Organization Active NPI

Coastal Carolina Neonatology, PLLC

Doing business as CCN-Whiteville

  • Pediatrics Physician
  • Whiteville, NC
National Provider Identifier
1649525064
Registry record updated Oct 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
COASTAL CAROLINA NEONATOLOGY, PLLC
Doing business as
CCN-Whiteville
Practice address
823 Jefferson St
Whiteville, NC 28472-3703
Phone
(910) 772-9202
Fax
(910) 772-9452
NPI assigned
Jul 23, 2012
Last updated
Oct 13, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2015

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

Authorized official

Name
Dr. Fernando Moya, MDNPI 1922005214
Title
President
Phone
(910) 772-9202

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

823 Jefferson St
Whiteville, NC 28472-3703

Mailing address

1915 Glen Meade Rd
Wilmington, NC 28403-6024
Phone (910) 772-9202

Other names 1

  • CCN-Whiteville Doing business as

National Provider Directory

National Provider Directory

Locations

823 Jefferson St
Whiteville, NC 28472
Phone (910) 642-6121

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1343001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444694400000",
    "number": "1649525064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 GLEN MEADE RD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036024",
            "telephone_number": "910-772-9202",
            "fax_number": "910-772-9452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 JEFFERSON ST",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284723703",
            "telephone_number": "910-772-9202",
            "fax_number": "910-772-9452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CAROLINA NEONATOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-23",
        "last_updated": "2015-10-13",
        "status": "A",
        "authorized_official_last_name": "MOYA",
        "authorized_official_first_name": "FERNANDO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-772-9202",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CCN-Whiteville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Whiteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2015; 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.