Coastal Medical Physicians, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

COASTAL MEDICAL PHYSICIANS, INC.

Doing business as

Coastal Medical

Practice address

10 Davol SQ Ste 300
Providence, RI 02903-4754

Phone

(401) 421-4000

Fax

(401) 272-1456

NPI assigned

Jan 14, 2021

Last updated

Feb 24, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

COASTAL MEDICAL PHYSICIANS, INC.As reported in NPPES

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

Authorized official

Name

Peter K Markell

Title

Evp & Cfo

Phone

(401) 444-7914

Specialties & licenses 1

Addresses

Other names 1

• Coastal Medical Doing business as

Part of

Coastal Medical Physicians

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Coastal Medical Physicians, Inc.

  dba Brown Health Medical Group Primary Care

  • Internal Medicine Physician
  • Providence, RI
  • NPI 1245008937
  NPPES parent name

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

{
    "created_epoch": "1610582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677196800000",
    "number": "1437748324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ELLENFIELD ST STE 101",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054541",
            "telephone_number": "401-444-6779",
            "fax_number": "401-444-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 DAVOL SQ STE 300",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034754",
            "telephone_number": "401-421-4000",
            "fax_number": "401-272-1456"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "593 Eddy St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029034923",
            "country_code": "US",
            "telephone_number": "401-444-6779",
            "fax_number": "401-444-6912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COASTAL MEDICAL PHYSICIANS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COASTAL MEDICAL PHYSICIANS, INC.",
        "enumeration_date": "2021-01-14",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A",
        "authorized_official_last_name": "MARKELL",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "EVP & CFO",
        "authorized_official_telephone_number": "401-444-7914"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brian Clyne, MD
• Coastal Care
• Coastal Medical Inc
• Coastal Medical Inc (Coastal Medical Lab)
• Coastal Medical Physicians, Inc. (Brown Health Medical Group Primary Care)
• Coastal Medical Physicians, Inc. (Coastal Medical)
• Coastal Medical Physicians, Inc. (Brown Health Medical Group Primary Care)
• Coastal Medical, Inc.
• Coastal Medical, Inc. (Coastal Medical - Elmhurst)
• Coastal Psychological Assessment

• Clinical Medical Laboratory in Providence, RI
• Providers in Providence, RI by specialty
• Clinical Medical Laboratory in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2023; 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.