NPIMap

Organization Active NPI

Coastal Podiatry, Inc

  • Podiatrist
  • Virginia Beach, VA
National Provider Identifier
1255356713
Registry record updated Apr 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
0103000759 Issued in VA
Legal business name
COASTAL PODIATRY, INC
Practice address
6477 College Park SQ
Suites 106
Virginia Beach, VA 23464-3611
Phone
(757) 523-0414
Fax
(757) 523-2047
NPI assigned
Jul 13, 2006
Last updated
Apr 27, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kathleen M. McGee
Title
Office Manager
Phone
(757) 523-0414

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 0103000759 VA Primary
Primary Podiatric Medicine Podiatrist 213EP1101X 0103000759 VA
Radiology Podiatrist 213ER0200X 0103000759 VA
Foot & Ankle Surgery Podiatrist 213ES0103X 0103000759 VA
Foot Surgery Podiatrist 213ES0131X 0103000759 VA

Addresses

Primary practice location

6477 College Park SQ
Suites 106
Virginia Beach, VA 23464-3611

Mailing address

6477 College Park SQ
Suites 106
Virginia Beach, VA 23464-3611
Phone (757) 523-0414

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20061024000572 VA Part B Supplier - Clinic/Group Practice 9830196468 Receives reassigned benefits from 2 practitioners
Practice locations: Virginia Beach, VA
O20100930036745 VA DME Supplier - Multi-Specialty - Physician 9830196468 Practice locations: Virginia Beach, VA

National Provider Directory

National Provider Directory

Locations

825 Fairfax Ave
#118
Norfolk, VA 23507
Phone (757) 446-5955

6477 College Park Sq
Ste 108
Virginia Beach, VA 23464
Phone (757) 523-0414

Practitioners & affiliated clinicians

Practitioners 64

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 64

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493251200000",
    "number": "1255356713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6477 COLLEGE PARK SQ",
            "address_2": "SUITES 106",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234643611",
            "telephone_number": "757-523-0414",
            "fax_number": "757-523-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6477 COLLEGE PARK SQ",
            "address_2": "SUITES 106",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234643611",
            "telephone_number": "757-523-0414",
            "fax_number": "757-523-2047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL PODIATRY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2017-04-27",
        "status": "A",
        "authorized_official_last_name": "MCGEE",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "757-523-0414"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "VA",
            "license": "0103000759",
            "primary": true
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "VA",
            "license": "0103000759",
            "primary": false
        },
        {
            "code": "213ER0200X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Radiology",
            "state": "VA",
            "license": "0103000759",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "VA",
            "license": "0103000759",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "VA",
            "license": "0103000759",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.