NPIMap

Organization Active NPI

Coastal Psychiatric Walk-in Corp

Doing business as Coastal Psychiatric Urgent Care

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Melbourne, FL
National Provider Identifier
1497531529
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
COASTAL PSYCHIATRIC WALK-IN CORP
Doing business as
Coastal Psychiatric Urgent Care
Practice address
1335 Valentine St
Melbourne, FL 32901-3127
Phone
(321) 586-5444
Fax
(321) 319-9712
NPI assigned
Sep 5, 2023
Last updated
Sep 5, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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

Authorized official

Name
Dr. Jessica Karle, PHDNPI 1689941536
Title
Ceo
Phone
(321) 586-5444

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

1335 Valentine St
Melbourne, FL 32901-3127

Mailing address

1335 Valentine St
Melbourne, FL 32901-3127
Phone (321) 586-5444

Other names 1

  • Coastal Psychiatric Urgent Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230920004401 FL Part B Supplier - Clinic/Group Practice 7315391679 Receives reassigned benefits from 20 practitioners
Practice locations: Melbourne, FL

National Provider Directory

National Provider Directory

Locations

1335 Valentine St
Melbourne, FL 32901
Phone (321) 586-5444

Practitioners & affiliated clinicians

Practitioners 22

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.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1693872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693872000000",
    "number": "1497531529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1335 VALENTINE ST",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013127",
            "telephone_number": "321-586-5444",
            "fax_number": "321-319-9712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1335 VALENTINE ST",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013127",
            "telephone_number": "321-586-5444",
            "fax_number": "321-319-9712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL PSYCHIATRIC WALK-IN CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-05",
        "last_updated": "2023-09-05",
        "certification_date": "2023-08-31",
        "status": "A",
        "authorized_official_last_name": "KARLE",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "321-586-5444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Psychiatric Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; 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.