Coastal Functional Medicine

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

COASTAL FUNCTIONAL MEDICINE

Practice address

17800 Freitas LN
Fort Bragg, CA 95437-8329

Phone

(707) 440-9898

NPI assigned

Aug 6, 2021

Last updated

Aug 6, 2021By 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

Dr. Sandra Fleming, MDNPI 1790004091

Title

Ceo

Phone

(707) 440-9898

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Sandra Fleming, M.D.

  • Family Medicine Physician
  • Fort Bragg, CA
  • NPI 1790004091
  NPD Authorized official

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

{
    "created_epoch": "1628208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628208000000",
    "number": "1487328951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17800 FREITAS LN",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954378329",
            "telephone_number": "707-440-9898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17800 FREITAS LN",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954378329",
            "telephone_number": "707-440-9898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL FUNCTIONAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-06",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A",
        "authorized_official_last_name": "FLEMING",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "707-440-9898",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cep America - Neurology PC
• Anne Marie Cesario
• Deborah Chang
• Yulee Chang, PHARM.D.
• Coast Healthcare Supply (Karen Markard Jenkins)
• Code 3 Mind Health, Inc.
• Abraham P Cohen, CMT
• Tabetha Connell
• Phillip Conwell Jr., CRNA
• John Ernest Cottle Jr., D.O.

• Family Medicine Physician in Fort Bragg, CA
• Providers in Fort Bragg, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2021; 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.