Coastal Concierge Physical Therapy LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

COASTAL CONCIERGE PHYSICAL THERAPY LLC

Practice address

4213 Marblewood LN
Jacksonville, FL 32216-3614

Phone

(330) 704-8907

NPI assigned

Sep 28, 2020

Last updated

Sep 28, 2020By 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

Dana BrownNPI 1376926220

Title

Sole MBR

Phone

(330) 704-8907

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.

• Dana Brown, PT, DPT

  • Physical Therapist
  • Jacksonville, FL
  • NPI 1376926220
  Authorized official Same address or phone

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

{
    "created_epoch": "1601251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601251200000",
    "number": "1609483361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4213 MARBLEWOOD LN",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163614",
            "telephone_number": "330-704-8907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4213 MARBLEWOOD LN",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163614",
            "telephone_number": "330-704-8907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CONCIERGE PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-28",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-21",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "DANA",
        "authorized_official_title_or_position": "SOLE MBR",
        "authorized_official_telephone_number": "330-704-8907"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coastal Bay Behavioral Health, Inc
• Coastal Bay Health Services LLC
• Coastal Care Medical Center Inc
• Coastal Cognition and Language Center, PLLC
• Coastal Comfort Nemt LLC
• Coastal Cosmetic Center, PA
• Coastal Dermatology PA
• Coastal Enterprises of Jax Beach LLC
• Coastal Florida Hospitalist PL
• Coastal Hand Therapy and Rehabilitation Inc

• Physical Therapist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; 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.