Active NPI
Coastal Comprehensive Care PA
- Family Medicine Physician
- Sunset Beach, NC
National Provider Identifier
1457828253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- COASTAL COMPREHENSIVE CARE PA
- Practice address
- 710 Sunset Blvd N Ste a
Sunset Beach, NC 28468-4340 - Phone
- (910) 663-2273
- Fax
- (910) 663-4050
- NPI assigned
- Oct 30, 2018
- Last updated
- Jan 30, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Terresa A Long, NP
- Title
- President
- Phone
- (910) 663-2273
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Anesthesiology) Physician | 207LA0401X | |||
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | |||
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
710 Sunset Blvd N Ste a
Sunset Beach, NC 28468-4340
Mailing address
PO Box 2123
Bryson City, NC 28713-5123
Phone (910) 490-0490
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190128002886 | NC | Part B Supplier - Clinic/Group Practice | 9436496536 |
Receives reassigned benefits from 7 practitioners 1 other NPI on this enrollment Practice locations: Hickory, NC; Sunset Beach, NC; Whiteville, NC |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Pain Medicine (Anesthesiology) Physician
- Whiteville, NC
- NPI 1861161044
O20190128002886
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 34D2159876 | Coastal Comprehensive Care, PA | Accreditation | Jun 1, 2027 |
National Provider Directory
National Provider Directory- Tax ID family
- Coastal Comprehensive Care
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Pain Medicine (Anesthesiology) Physician
- Whiteville, NC
- NPI 1861161044
Ownership & related parties
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
-
- Pain Medicine (Anesthesiology) Physician
- Whiteville, NC
- NPI 1861161044
Practitioners & affiliated clinicians
Practitioners 8
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.
-
- Physician Assistant
- Sunset Beach, NC
- NPI 1043385123
-
- Family Nurse Practitioner
- Shallotte, NC
- NPI 1912289950
-
- Hearing Instrument Specialist
- Carolina Shores, NC
- NPI 1750432084
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540857600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1738195200000",
"number": "1457828253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2123",
"city": "BRYSON CITY",
"state": "NC",
"postal_code": "287135123",
"telephone_number": "910-490-0490",
"fax_number": "828-538-4441"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "710 SUNSET BLVD N STE A",
"city": "SUNSET BEACH",
"state": "NC",
"postal_code": "284684340",
"telephone_number": "910-663-2273",
"fax_number": "910-663-4050"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COASTAL COMPREHENSIVE CARE PA",
"organizational_subpart": "NO",
"enumeration_date": "2018-10-30",
"last_updated": "2025-01-30",
"certification_date": "2025-01-30",
"status": "A",
"authorized_official_last_name": "LONG",
"authorized_official_first_name": "TERRESA",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "910-663-2273",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "NP"
},
"taxonomies": [
{
"code": "207LA0401X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Anesthesiology, Addiction Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207LP2900X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Anesthesiology, Pain Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sunset Beach, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; 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.