Coastal Carolina Health Care PA
Organization Active NPI Diagnostic Radiology Physician · New Bern, NC
NPI 1447290010 · NPPES record last updated Feb 1, 2024
Key facts
- NPI
- 1447290010
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- Legal business name
- COASTAL CAROLINA HEALTH CARE PA
- Practice address
- 1030 Medical Park Ave
New Bern, NC 28562-5248 - Phone
- (252) 637-5480
- Fax
- (252) 637-2514
- NPI assigned
- Jun 8, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Stephen Nuckolls
- Title
- Ceo
- Phone
- (252) 514-6685
Other NPIs on the same Medicare enrollment 18
Member organizations 1
Practitioners 13
-
Alex David Bibbey, M.D.
-
Thomas David Fisher, M.D.
-
Elikem Kofi Gbeddy, M.D.
-
Loren Ashley Buck, D.O.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031230000224 | NC | Part B Supplier - Clinic/Group Practice | 9739087693 |
Receives reassigned benefits from 137 practitioners 23 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: New Bern, NC; Morehead City, NC; Havelock, NC; Bayboro, NC |
National Provider Directory
Locations
1000 Medical Park Ave
New Bern, NC 28562
Phone (252) 634-3278
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician |
2085R0202X | Yes | ||
| Radiology Clinic/Center | 261QR0200X |
Addresses
Primary practice location
1030 Medical Park Ave
New Bern, NC 28562-5248
Mailing address
1030 Medical Park Ave
New Bern, NC 28562-5248
Phone (252) 637-5480
Other names
- CCHC Imaging Center
Other providers in New Bern, NC
- Chetina Cloud
- Coastal Carolina Health Care
- Coastal Carolina Health Care PA
- Coastal Carolina Health Care PA
- Coastal Carolina Health Care PA
- Coastal Carolina Health Care PA
- Coastal Carolina Health Care PA
- Coastal Carolina Health Care PA
- Coastal Carolina Health Care PA
- Coastal Carolina Health Care PA
All providers in New Bern, NC · Diagnostic Radiology Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 1, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.