Coastal Carolina Foot & Ankle Association PA

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

230 Issued in NC

Legal business name

COASTAL CAROLINA FOOT & ANKLE ASSOCIATION PA

Practice address

114 N Norwood St
Wallace, NC 28466-2730

Phone

(910) 285-3362

Fax

(910) 285-6683

NPI assigned

May 22, 2008

Last updated

Sep 17, 2013By 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

Mrs. Kathy N Walker

Title

Practice Administrator

Phone

(910) 343-8889

Specialties & licenses 2

Addresses

Other identifiers 5

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Coastal Carolina Foot & Ankle Associates PA

  • Foot & Ankle Surgery Podiatrist
  • Wilmington, NC
  • NPI 1205885159

  Member Of

  NPD member

Locations

Practitioners 3

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.

• Elizabeth Bass Daughtry, DPM

  • Foot & Ankle Surgery Podiatrist
  • Dunn, NC
  • NPI 1457309981
  NPD (past)
• Thomas James Hagan, DPM

  • Primary Podiatric Medicine Podiatrist
  • New Bern, NC
  • NPI 1962406991

  Foot & Ankle Surgery

  NPD (past)
• Tyler K Hagan, DPM

  • Foot & Ankle Surgery Podiatrist
  • New Bern, NC
  • NPI 1588955231
  NPD (past)

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379376000000",
    "number": "1639336027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 N NORWOOD ST",
            "city": "WALLACE",
            "state": "NC",
            "postal_code": "284662730",
            "telephone_number": "910-285-3362",
            "fax_number": "910-285-6683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 N NORWOOD ST",
            "city": "WALLACE",
            "state": "NC",
            "postal_code": "284662730",
            "telephone_number": "910-285-3362",
            "fax_number": "910-285-6683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CAROLINA FOOT & ANKLE ASSOCIATION PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-22",
        "last_updated": "2013-09-17",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "910-343-8889",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NC",
            "license": "230",
            "primary": true
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NC",
            "license": "449",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "2347992",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "0152P",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890152P",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "DR7169",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "B1114",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carolina Residential Services, Inc.
• Orlando Carr
• Ashley Cavenaugh
• Christian's House of Hope, Inc.
• Coastal Breeze Healthcare
• Coastline Care Inc
• Community Care Support Services Inc
• Continuum Care Corporation
• Gary Stephen Crawford, M.D.
• Daniel M Ricci M.D. P.a.

• Foot & Ankle Surgery Podiatrist in Wallace, NC
• Providers in Wallace, NC by specialty
• Foot & Ankle Surgery Podiatrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2013; 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.