Coastal Physical Therapy

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

Legal business name

COASTAL PHYSICAL THERAPY

Practice address

3114 Randall Pkwy Ste 2
Wilmington, NC 28403-2590

Phone

(910) 799-4199

NPI assigned

Feb 21, 2006

Organization subpart

No

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

Authorized official

Name

Cathy PoulosNPI 1467416057

Title

Owner

Phone

(910) 799-4199

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cathy Poulos, P.T.

  • Physical Therapist
  • Wilmington, NC
  • NPI 1467416057
  NPD (past) Authorized official

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1285609560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3114 RANDALL PKWY STE 2",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284032590",
            "telephone_number": "910-799-4199",
            "fax_number": "910-799-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3114 RANDALL PKWY STE 2",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284032590",
            "telephone_number": "910-799-4199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-21",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "POULOS",
        "authorized_official_first_name": "CATHY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-799-4199"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7210529",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0238Q",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Coastal Optical of Wilmington
• Coastal Optical Services of Wilmington
• Coastal Optical, Inc.
• Coastal Pediatric Associates, PLLC
• Coastal Pharmacy and Compounding
• Coastal Pulmonary Medicine PA
• Coastal Rehabilitation Associates
• Coastal Rehabilition Associates
• Coastal Speech and Language PLLC
• Coastal Speech Therapy Inc

• Pediatric Physical Therapist in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Pediatric Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.