Coastal Pain Management PLLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

COASTAL PAIN MANAGEMENT PLLC

Practice address

14 Live Oak St Ste C-4
Gulf Breeze, FL 32561-4484

Phone

(850) 490-8862

Fax

(937) 915-0250

NPI assigned

May 27, 2020

Organization subpart

No

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

Authorized official

Name

Laura Tunke, MDNPI 1588981849

Title

Owner

Phone

(850) 490-8862

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

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

• Laura Tunke, MD

  • Pain Medicine (Anesthesiology) Physician
  • Gulf Breeze, FL
  • NPI 1588981849
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1590537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590969600000",
    "number": "1609499524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 LIVE OAK ST STE C-4",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325614484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 LIVE OAK ST STE C-4",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325614484",
            "telephone_number": "850-490-8862",
            "fax_number": "937-915-0250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL PAIN MANAGEMENT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-27",
        "last_updated": "2020-06-01",
        "certification_date": "2020-06-01",
        "status": "A",
        "authorized_official_last_name": "TUNKE",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-490-8862",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Harris Clayton
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• Coastal Medical Integration Inc
• Coastal Wound Care Specialist LLC
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• Larissa Coffey
• Shelly Lynn Cohn, FNP-BC
• Coleman Orthopaedic LLC

• Clinic/Center in Gulf Breeze, FL
• Providers in Gulf Breeze, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2020; 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.