Coastal Community Care LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

COASTAL COMMUNITY CARE LLC

Practice address

731 Airport Rd Ste G
Panama City, FL 32405-4031

Phone

(850) 852-1058

Fax

(850) 852-1059

NPI assigned

Feb 19, 2020

Organization subpart

No

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

Authorized official

Name

Cassaundra NanceNPI 1417251653

Title

Owner

Phone

(850) 319-5693

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

Practitioners 1

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

• Cassaundra Lynette Nance

  • Specialist
  • Panama City, FL
  • NPI 1417251653
  NPD Authorized official

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

{
    "created_epoch": "1582070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591833600000",
    "number": "1336772292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 AIRPORT RD STE G",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054031",
            "telephone_number": "850-852-1058",
            "fax_number": "850-852-1059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 AIRPORT RD STE G",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054031",
            "telephone_number": "850-852-1058",
            "fax_number": "850-852-1059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL COMMUNITY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-19",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A",
        "authorized_official_last_name": "NANCE",
        "authorized_official_first_name": "CASSAUNDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-319-5693"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336772292",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ccc@coastalcaresfl.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "731 Airport Rd Ste G",
            "city": "Panama City",
            "state": "FL",
            "country_code": "US",
            "postal_code": "324054031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Coastal DME, LLC
• Coastal Kidney Centers LLC
• Coastal Mobility Transportation, LLC
• Coastal OB GYN PA
• Coastal Rehabilitation LLC

• In Home Supportive Care Agency in Panama City, FL
• Providers in Panama City, FL by specialty
• In Home Supportive Care Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.