Coast Multi-Specialty Medical Group P.a

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

ME80264 Issued in FL

Legal business name

COAST MULTI-SPECIALTY MEDICAL GROUP P.A

Practice address

480 SW Main Blvd
Lake City, FL 32025-5269

Phone

(386) 758-1965

Fax

(386) 758-6923

NPI assigned

Feb 23, 2007

Organization subpart

No

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

Authorized official

Name

Dr. J. Anthony Trott, M.D.NPI 1346375896

Title

President

Phone

(386) 758-1965

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• CMSMG Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

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

• J Anthony Trott, M.D.

  • Internal Medicine Physician
  • Lake City, FL
  • NPI 1346375896
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419292800000",
    "number": "1306971833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1762",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320561762",
            "telephone_number": "386-758-1965",
            "fax_number": "386-758-6923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 SW MAIN BLVD",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320255269",
            "telephone_number": "386-758-1965",
            "fax_number": "386-758-6923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COAST MULTI-SPECIALTY MEDICAL GROUP P.A",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2014-12-23",
        "status": "A",
        "authorized_official_last_name": "TROTT",
        "authorized_official_first_name": "J.",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-758-1965",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "FL",
            "license": "ME80264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "K2456",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CMSMG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Clinical Pet of Lake City
• Club Community Care LLC
• Jourdan Ashley Clum, ARNP
• CMS Professional Transport, Inc.
• Coast Dental P.a.
• Melissa Sue Cobb
• Morgan Renald Cobran, D.D.S.
• Jonathan D Cohen, PH.D.
• Albneisha D Coker
• Cole Optics, LLC

• Procedural Dermatology Physician in Lake City, FL
• Providers in Lake City, FL by specialty
• Procedural Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2014; 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.