Coastal Urology P a

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

ME72919 Issued in FL

Legal business name

COASTAL UROLOGY P A

Practice address

4012 Commons Dr W
Suite 100
Destin, FL 32541-8422

Phone

(850) 837-0442

Fax

(850) 837-1051

NPI assigned

Aug 25, 2006

Last updated

Aug 22, 2020By 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

Debbie Thuy Nguyen

Title

Office Manager

Phone

(850) 837-0442

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 3

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.

• Ted Chung, M.D.

  • Urology Physician
  • Destin, FL
  • NPI 1639148166
  Medicare reassignment NPD
• Ann Thuy Nguyen, M.D.

  • Gynecology Physician
  • Destin, FL
  • NPI 1962518811
  NPD (past)
• John Quang Nguyen, M.D.

  • Family Medicine Physician
  • Fort Walton Beach, FL
  • NPI 1942452255
  NPD (past)

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396853941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936",
            "city": "SHALIMAR",
            "state": "FL",
            "postal_code": "325790936",
            "telephone_number": "850-837-0442",
            "fax_number": "850-837-1051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4012 COMMONS DR W",
            "address_2": "SUITE 100",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325418422",
            "telephone_number": "850-837-0442",
            "fax_number": "850-837-1051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL UROLOGY P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_middle_name": "THUY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "850-837-0442"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "FL",
            "license": "ME72919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Staceyann Simone Clarke
• Jennifer Clauson, LCSW
• Clear Mountain Emergency Physicians LLC
• Clear Vision Eyecare Associates LLC
• Coastal Pediatric Group
• Coastal Vascular and Interventional PLLC
• Coastal Vascular and Interventional PLLC
• Johannes Hendrik Coetzee, MD, MPH
• Comfortable Care Dental Health Professionals, P.a. (The Center for Cosmetic and Family Dentistry - Destin)
• Commons Drive Family Medicine

• Urology Physician in Destin, FL
• Providers in Destin, FL by specialty
• Urology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.