Active NPI
Coastal Southeastern United Care LLC
- Community/Behavioral Health Agency
- Supply, NC
National Provider Identifier
1346477403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- COASTAL SOUTHEASTERN UNITED CARE LLC
- Practice address
- 10 Doctors Circle
Suite 6
Supply, NC 28462 - Phone
- (910) 755-5222
- Fax
- (910) 755-5255
- NPI assigned
- Jun 16, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Shannon Ashley Atkinson, LCSW
- Title
- VP, Home and Community Services
- Phone
- (843) 806-2695
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Psychologist | 103T00000X | |||
| Case Management Agency | 251B00000X | |||
| Community/Behavioral Health Agency | 251S00000X | Primary | ||
| Clinical Medical Laboratory | 291U00000X |
Addresses
Primary practice location
10 Doctors Circle
Suite 6
Supply, NC 28462
Mailing address
305 Commerce Ave
Suite 102
Morehead City, NC 28557
Phone (252) 773-0195
Other practice location 1
100A Memory Plz
Whiteville, NC 28472-2640
Phone (910) 640-2230
Other practice location 2
305 Commerce Ave Ste 102
Morehead City, NC 28557-2971
Phone (252) 772-0195
Other practice location 3
401 W 27th St
Lumberton, NC 28358-3019
Phone (910) 370-0434
Other practice location 4
1201 S 16th St Ste B
Wilmington, NC 28401-6419
Phone (910) 769-4971
Other practice location 5
2550 Court Dr Ste 103
Gastonia, NC 28054-2152
Phone (704) 215-5822
Other practice location 6
1201 S 16th St Ste B
Wilmington, NC 28401
Phone (910) 769-4971
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8302940 | Medicaid | NC | |
| B913 | Other | NC | MEDICARE |
| 8302940B | Medicaid | NC | |
| 8302940H | Medicaid | NC | |
| 8302940G | Medicaid | NC |
Other names 1
- Coastal Southeastern United Care
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20121228000121 | NC | Part B Supplier - Clinic/Group Practice | 6204089188 |
Receives reassigned benefits from 14 practitioners 1 other NPI on this enrollment Practice locations: Bolivia, NC; Wilmington, NC; Whiteville, NC; Supply, NC; Shallotte, NC; Morehead City, NC; Lumberton, NC; Gastonia, NC |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Community/Behavioral Health Agency
- Bladenboro, NC
- NPI 1093032310
O20121228000121
National Provider Directory
National Provider DirectoryLocations
818 S Main St
Bladenboro, NC 28320
Phone (910) 755-5222
10 Referendum Dr NE
#F115
Bolivia, NC 28422
Phone (910) 253-5801
1040 X Ray Dr
Gastonia, NC 28054
Phone (704) 215-5444
2590 Onslow Dr
Jacksonville, NC 28540
305 Commerce Ave
Ste 102
Morehead City, NC 28557
Phone (252) 288-9539
3640 Express Dr
Shallotte, NC 28470
Phone (910) 294-8471
100 Memory Plz
#A
Whiteville, NC 28472
Phone (910) 640-2230
Practitioners & affiliated clinicians
Practitioners 29
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatric/Mental Health Nurse Practitioner
- Charlotte, NC
- NPI 1215688700
NC
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245110400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1756771200000",
"number": "1346477403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 COMMERCE AVE",
"address_2": "SUITE 102",
"city": "MOREHEAD CITY",
"state": "NC",
"postal_code": "28557",
"telephone_number": "252-773-0195",
"fax_number": "252-773-0214"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 DOCTORS CIRCLE",
"address_2": "SUITE 6",
"city": "SUPPLY",
"state": "NC",
"postal_code": "28462",
"telephone_number": "910-755-5222",
"fax_number": "910-755-5255"
}
],
"practiceLocations": [
{
"address_1": "100A Memory Plz",
"address_purpose": "LOCATION",
"city": "Whiteville",
"state": "NC",
"postal_code": "284722640",
"country_code": "US",
"telephone_number": "910-640-2230",
"fax_number": "910-640-1625",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "305 Commerce Ave Ste 102",
"address_purpose": "LOCATION",
"city": "Morehead City",
"state": "NC",
"postal_code": "285572971",
"country_code": "US",
"telephone_number": "252-772-0195",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "401 W 27th St",
"address_purpose": "LOCATION",
"city": "Lumberton",
"state": "NC",
"postal_code": "283583019",
"country_code": "US",
"telephone_number": "910-370-0434",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1201 S 16th St Ste B",
"address_purpose": "LOCATION",
"city": "Wilmington",
"state": "NC",
"postal_code": "284016419",
"country_code": "US",
"telephone_number": "910-769-4971",
"fax_number": "910-769-6015",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2550 Court Dr Ste 103",
"address_purpose": "LOCATION",
"city": "Gastonia",
"state": "NC",
"postal_code": "280542152",
"country_code": "US",
"telephone_number": "704-215-5822",
"fax_number": "704-215-5824",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1201 S 16th St Ste B",
"address_purpose": "LOCATION",
"city": "Wilmington",
"state": "NC",
"postal_code": "28401",
"country_code": "US",
"telephone_number": "910-769-4971",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "COASTAL SOUTHEASTERN UNITED CARE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2009-06-16",
"last_updated": "2025-09-02",
"certification_date": "2024-01-19",
"status": "A",
"authorized_official_last_name": "ATKINSON",
"authorized_official_first_name": "SHANNON",
"authorized_official_middle_name": "ASHLEY",
"authorized_official_title_or_position": "VP, HOME AND COMMUNITY SERVICES",
"authorized_official_telephone_number": "843-806-2695",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "LCSW"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": null,
"license": null,
"primary": false
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8302940",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "B913",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8302940B",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8302940H",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8302940G",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Coastal Southeastern United Care",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Supply, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; 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.