Organization Active NPI

Coastal Prosthetics and Orthotics, LLC

  • Prosthetic/Orthotic Supplier
  • Virginia Beach, VA
National Provider Identifier
1386270643
Registry record updated Mar 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
COASTAL PROSTHETICS AND ORTHOTICS, LLC
Practice address
1008 First Colonial Rd
Virginia Beach, VA 23454-3071
Phone
(757) 892-5300
Fax
(757) 892-5303
NPI assigned
Mar 19, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2020

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

Authorized official

Name
Brittany Siverd
Title
Administrative Executive
Phone
(757) 892-5300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

1008 First Colonial Rd
Virginia Beach, VA 23454-3071

Mailing address

433 Network Sta
Chesapeake, VA 23320-3851
Phone (757) 892-5300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211115001499 VA DME Supplier - Certified Orth/Pros/Pedorthist 7618189622 Practice locations: Virginia Beach, VA

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Coastal Prosthetics and Orthotics,1008 First Colonial Rd, Virginia Beach, VA 23454-3071(757) 892-5300 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Limb Prostheses Does not accept assignmentParticipating since Sep 24, 2001

National Provider Directory

National Provider Directory
Tax ID family
Coastal Prosthetics and Orthotics LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1134 N Road St
Ste 8
Elizabeth Cty, NC 27909
Phone (252) 335-4619

1924 Landstown Centre Way
Ste 105
Virginia Beach, VA 23456
Phone (757) 592-5300

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1584576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584576000000",
    "number": "1386270643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 NETWORK STA",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233203851",
            "telephone_number": "757-892-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 FIRST COLONIAL RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234543071",
            "telephone_number": "757-892-5300",
            "fax_number": "757-892-5303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL PROSTHETICS AND ORTHOTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-19",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A",
        "authorized_official_last_name": "SIVERD",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_title_or_position": "ADMINISTRATIVE EXECUTIVE",
        "authorized_official_telephone_number": "757-892-5300"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.