Novant Health Medical Group Coastal Region, LLC

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

Legal business name

NOVANT HEALTH MEDICAL GROUP COASTAL REGION, LLC

Practice address

1912 Tradd CT
Wilmington, NC 28401-6637

Phone

(910) 815-5982

NPI assigned

Mar 3, 2021

Organization subpart

No

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

Authorized official

Name

Shala Davis

Title

RCS Manager

Phone

(704) 303-7517

Specialties & licenses 1

Addresses

Other names 1

• Coastal Thoracic Surgical Associates Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert Michael Cortina, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Wilmington, NC
  • NPI 1952371890

  Thoracic Surgery (Cardiothoracic Vascular Surgery)

  NPD
• Megan Whitley Herrington, PA

  • Physician Assistant
  • Wilmington, NC
  • NPI 1821279589
  NPD
• Walker Jackman Jamar, PA

  • Physician Assistant
  • Wilmington, NC
  • NPI 1295002012
  NPD
• Mollie O'Mara Lindholm, PA

  • Physician Assistant
  • Wilmington, NC
  • NPI 1518203017
  NPD

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

{
    "created_epoch": "1614729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626652800000",
    "number": "1497340327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936857",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311936857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1912 TRADD CT",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284016637",
            "telephone_number": "910-815-5982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT HEALTH MEDICAL GROUP COASTAL REGION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-03",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "SHALA",
        "authorized_official_title_or_position": "RCS MANAGER",
        "authorized_official_telephone_number": "704-303-7517"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Thoracic Surgical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Novant Health Medical Group Coastal Region, LLC
• Novant Health Medical Group Coastal Region, LLC
• Novant Health Medical Group Coastal Region, LLC
• Novant Health Medical Group Coastal Region, LLC
• Novant Health Medical Group Coastal Region, LLC
• Novant Health Medical Group Coastal Region, LLC
• Novant Health Medical Group Coastal Region, LLC
• Novant Health Medical Group Coastal Region, LLC
• Novant Health Medical Group Coastal Region, LLC
• Novant Health Medical Group Coastal Region, LLC

• All providers in Wilmington, NC
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; 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.