Coastal Community Retirement Corporation

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

COASTAL COMMUNITY RETIREMENT CORPORATION

Doing business as

Marsh's Edge

Practice address

136 Marshsedge Lane
St. Simons Island, GA 31522

Phone

(912) 291-2001

NPI assigned

Aug 9, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Robert B Rees

Title

Executive Director

Phone

(912) 291-2004

Specialties & licenses 1

Addresses

Other names 1

• Marsh's Edge Doing business as

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295745453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 MARSHSEDGE LANE",
            "city": "ST. SIMONS ISLAND",
            "state": "GA",
            "postal_code": "31522",
            "telephone_number": "912-291-2001",
            "fax_number": "912-291-2098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 MARSHSEDGE LANE",
            "city": "ST. SIMONS ISLAND",
            "state": "GA",
            "postal_code": "31522",
            "telephone_number": "912-291-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL COMMUNITY RETIREMENT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "REES",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "912-291-2004"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marsh's Edge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephanie Rene Chapman, D.O.
• Joshua Childers, PSY.D.
• Emily K Claros, DPT, PT
• Brandon R Clements, D.M.D.
• Coastal Community Health Services, Inc. (Coastal Community Health St. Simon's Island Pediatrics)
• Coastal Community Retirement Corporation
• Coastal Eye Care LLC (Coastal Eye Care)
• Coastal Kids Dentistry
• Coastal Oral Surgery Associates
• Crane Physical Therapy and Wellness

• Physical Therapy Clinic/Center in St Simons Island, GA
• Providers in St Simons Island, GA by specialty
• Physical Therapy Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.