Coastal Medical Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

COASTAL MEDICAL INC

Practice address

10 Davol SQ
Suite 400
Providence, RI 02903-4754

Phone

(401) 421-4000

Fax

(401) 453-3258

NPI assigned

Oct 3, 2005

Last updated

Apr 1, 2016By 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

Meryl Moss

Title

Coo

Phone

(401) 421-4000

Specialties & licenses 10

Addresses

Other identifiers 1

Locations

Practitioners 21

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.

• Michael James Carnathan, MD

  • Family Medicine Physician
  • Bethlehem, PA
  • NPI 1851529093
  NPD
• Evelyn Asante, NP

  • Nurse Practitioner
  • Cumberland, RI
  • NPI 1639165004
  NPD (past)
• Karen Lynn Azar, RNP

  • Family Nurse Practitioner
  • Smithfield, RI
  • NPI 1700097946
  NPD (past)
• Lynne A Bisbano, PA-C

  • Physician Assistant
  • Providence, RI
  • NPI 1245234517
  NPD (past)
• Michael F Blundin Jr., MD

  • Pulmonary Disease Physician
  • Riverside, RI
  • NPI 1982821484

  Critical Care Medicine

  NPD (past)
• Regina Brannon, NP

  • Nurse Practitioner
  • Cranston, RI
  • NPI 1326033457
  NPD (past)
• Jeffrey M Brody, MD

  • Diagnostic Radiology Physician
  • Providence, RI
  • NPI 1851380653
  NPD (past)
• Joseph Campbell, MD

  • Internal Medicine Physician
  • Cranston, RI
  • NPI 1891780573
  NPD (past)
• Fred Ferri, MD

  • Internal Medicine Physician
  • Johnston, RI
  • NPI 1013903400
  NPD (past)
• Patrick George Lachut, MPT

  • Physical Therapist
  • Cranston, RI
  • NPI 1821000589
  NPD (past)
• John Won Lee, PH.D., M.A., M.B.A.

  • Clinical Psychologist
  • Providence, RI
  • NPI 1962638007
  NPD (past)
• Susan Pitt, PA

  • Physician Assistant
  • Cranston, RI
  • NPI 1194710350
  NPD (past)

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459468800000",
    "number": "1609863828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 DAVOL SQ",
            "address_2": "SUITE 400",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034754",
            "telephone_number": "401-421-4000",
            "fax_number": "401-453-3258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 DAVOL SQ",
            "address_2": "SUITE 400",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034754",
            "telephone_number": "401-421-4000",
            "fax_number": "401-453-3258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL MEDICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-03",
        "last_updated": "2016-04-01",
        "status": "A",
        "authorized_official_last_name": "MOSS",
        "authorized_official_first_name": "MERYL",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "401-421-4000"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CM13413",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dorothy Close
• David Robert Cloutier, MD
• Kathleen Cloutier
• Brian Clyne, MD
• Coastal Care
• Coastal Medical Inc (Coastal Medical Lab)
• Coastal Medical Physicians, Inc. (Brown Health Medical Group Primary Care)
• Coastal Medical Physicians, Inc. (Coastal Medical)
• Coastal Medical Physicians, Inc. (Coastal Medical)
• Coastal Medical Physicians, Inc. (Brown Health Medical Group Primary Care)

• Internal Medicine Physician in Providence, RI
• Providers in Providence, RI by specialty
• Internal Medicine Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2016; 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.