NPIMap

Organization Active NPI

Coastal Family Health Center, Inc.

Doing business as CFHC-Gulfport Health Center Extensioin

  • Federally Qualified Health Center (FQHC)
  • Gulfport, MS
National Provider Identifier
1427364397
Registry record updated Aug 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COASTAL FAMILY HEALTH CENTER, INC.
Doing business as
CFHC-Gulfport Health Center Extensioin
Practice address
1408 44TH Ave
Gulfport, MS 39501-2554
Phone
(228) 374-2494
Fax
(228) 374-0856
NPI assigned
Aug 30, 2010
Last updated
Aug 30, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2010

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

Authorized official

Name
Angelique Greer
Title
Chief Executive Officer
Phone
(228) 374-2494

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

1408 44TH Ave
Gulfport, MS 39501-2554

Mailing address

PO Box 475
Biloxi, MS 39533-0475
Phone (228) 374-2494

Other names 1

  • CFHC-Gulfport Health Center Extensioin Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040108000698 MS Part B Supplier - Clinic/Group Practice 8628989654 Receives reassigned benefits from 90 practitioners
37 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: MC Lain, MS; Moss Point, MS; Ocean Springs, MS; Pass Christian, MS; Richton, MS; State Line, MS; Vancleave, MS; Waveland, MS…

Other NPIs on the same Medicare enrollment 37

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 37

National Provider Directory

National Provider Directory

Locations

1408 44th Ave
Gulfport, MS 39501
Phone (228) 575-1777

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1283126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283126400000",
    "number": "1427364397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 475",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395330475",
            "telephone_number": "228-374-2494",
            "fax_number": "228-374-0856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1408 44TH AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012554",
            "telephone_number": "228-374-2494",
            "fax_number": "228-374-0856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL FAMILY HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-30",
        "last_updated": "2010-08-30",
        "status": "A",
        "authorized_official_last_name": "GREER",
        "authorized_official_first_name": "ANGELIQUE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "228-374-2494"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CFHC-Gulfport Health Center Extensioin",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gulfport, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2010; 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.