Coastal Care Residence LLC

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

COASTAL CARE RESIDENCE LLC

Practice address

216 Apollo Beach Blvd
Apollo Beach, FL 33572

Phone

(727) 674-1800

NPI assigned

Sep 18, 2023

Last updated

May 6, 2024By 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

Chevelle R Jordan, RNNPI 1932729241

Title

Owner

Phone

(727) 674-1800

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Chevelle R Jordan, REGISTERED NURSE

  • General Practice Registered Nurse
  • Ruskin, FL
  • NPI 1932729241
  NPD Authorized official

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714953600000",
    "number": "1336927870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 APOLLO BEACH BLVD # 182",
            "city": "APOLLO BEACH",
            "state": "FL",
            "postal_code": "335722251",
            "telephone_number": "727-417-1723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 APOLLO BEACH BLVD",
            "city": "APOLLO BEACH",
            "state": "FL",
            "postal_code": "33572",
            "telephone_number": "727-674-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CARE RESIDENCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-18",
        "last_updated": "2024-05-06",
        "certification_date": "2024-04-25",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "CHEVELLE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-674-1800",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jayme Leigh Chambers, LMHC
• Chantina Wilson LLC
• Chatterbug Pediatric Therapy LLC
• Citrus Orthopedic Products, Inc
• Citrus Orthopedics
• Coastal Primary Care and Wellness LLC
• Coastal Senior Living Facility LLC (Coastal Senior Living)
• Brooke Elizabeth Cockson, MS, RDN, LDN
• Christi Colbert
• Carolyne P Cole, LMFT

• Developmentally Disabled Services Day Training Agency in Apollo Beach, FL
• Providers in Apollo Beach, FL by specialty
• Developmentally Disabled Services Day Training Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; 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.