NPIMap

Organization Active NPI

Coastal Health & Wellness

  • Federally Qualified Health Center (FQHC)
  • Texas City, TX
National Provider Identifier
1619667565
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COASTAL HEALTH & WELLNESS
Practice address
1805 13TH Ave N
Texas City, TX 77590-5498
Phone
(409) 938-2234
NPI assigned
May 12, 2023
Organization subpart
Yes
Parent organization
COASTAL HEALTH & WELLNESSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 18, 2023

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

Authorized official

Name
Ami Cotharn, RN, MSN
Title
Chief Operating Officer
Phone
(409) 938-2218

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1805 13TH Ave N
Texas City, TX 77590-5498

Mailing address

PO Box 939
La Marque, TX 77568-0939
Phone (409) 938-2218

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110624000285 TX Part B Supplier - Clinic/Group Practice 0143215954 Receives reassigned benefits from 32 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Galveston, TX; Texas City, TX

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Galveston Cty Coordinat

Locations

2000 Texas Ave
#200
Texas City, TX 77590
Phone (409) 949-3406

9850 Emmett F Lowry Expy
Ste C
Texas City, TX 77591
Phone (409) 938-2234

9850 Emmett F Lowry Expy
Ste C103
Texas City, TX 77591
Phone (409) 938-2234

Practitioners & affiliated clinicians

Practitioners 46

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

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1683849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684368000000",
    "number": "1619667565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 939",
            "city": "LA MARQUE",
            "state": "TX",
            "postal_code": "775680939",
            "telephone_number": "409-938-2218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 13TH AVE N",
            "city": "TEXAS CITY",
            "state": "TX",
            "postal_code": "775905498",
            "telephone_number": "409-938-2234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL HEALTH & WELLNESS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COASTAL HEALTH & WELLNESS",
        "enumeration_date": "2023-05-12",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A",
        "authorized_official_last_name": "COTHARN",
        "authorized_official_first_name": "AMI",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "409-938-2218",
        "authorized_official_credential": "RN, MSN"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Texas City, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 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.