NPIMap

Organization Active NPI

Coastal Home Care, LLC

  • In Home Supportive Care Agency
  • Augusta, GA
National Provider Identifier
1265873368
Registry record updated Jun 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
COASTAL HOME CARE, LLC
Practice address
3633 Wheeler Rd Ste 330
Augusta, GA 30909-6552
Phone
(706) 955-8783
NPI assigned
Jul 17, 2013
Last updated
Jun 8, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2026

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

Authorized official

Name
Joseph Bonaccorsi
Title
Chief Legal Officer
Phone
(312) 762-9999

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 016-R-0270 GA
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

3633 Wheeler Rd Ste 330
Augusta, GA 30909-6552

Mailing address

33 S State St FL 5
Chicago, IL 60603-2804
Phone (312) 762-9999

Other practice location 1

1149 Cornell Ave Ste 1A
Savannah, GA 31406-2757
Phone (912) 354-3680

Other identifiers 1

IdentifierTypeStateIssuer
000609958AYMedicaidGA

National Provider Directory

National Provider Directory
Tax ID family
Coastal Home Care LLC29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

Organizations that report the same tax identification number in the National Provider Directory.

View all 28

Locations

3633 Wheeler Rd
Ste 330
Augusta, GA 30909
Phone (706) 955-8783

NPI Registry JSON

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

{
    "created_epoch": "1374019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780876800000",
    "number": "1265873368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 S STATE ST FL 5",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606032804",
            "telephone_number": "312-762-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3633 WHEELER RD STE 330",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309096552",
            "telephone_number": "706-955-8783"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1149 Cornell Ave Ste 1A",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314062757",
            "country_code": "US",
            "telephone_number": "912-354-3680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COASTAL HOME CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-17",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A",
        "authorized_official_last_name": "BONACCORSI",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CHIEF LEGAL OFFICER",
        "authorized_official_telephone_number": "312-762-9999"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "GA",
            "license": "016-R-0270",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000609958AY",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.