NPIMap

Organization Active NPI

Coastal Eye Care LLC

  • Optometrist
  • Spanish Fort, AL
National Provider Identifier
1710433271
Registry record updated May 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
S486RA041 Issued in AL
Legal business name
COASTAL EYE CARE LLC
Practice address
10184 Eastern Shore Blvd
Suite a
Spanish Fort, AL 36527-5814
Phone
(251) 301-5650
Fax
(251) 621-9645
NPI assigned
Aug 25, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2019

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

Authorized official

Name
Dr. Stephen M Gross, O.D.NPI 1831112317
Title
President
Phone
(251) 301-5650

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X S486RA041 AL Primary

Addresses

Primary practice location

10184 Eastern Shore Blvd
Suite a
Spanish Fort, AL 36527-5814

Mailing address

10184 Eastern Shore Blvd
Suite a
Spanish Fort, AL 36527-5814

Other names 1

  • Perspective Eye Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161221000455 AL Part B Supplier - Clinic/Group Practice 9830470335 Receives reassigned benefits from 3 practitioners
Practice locations: Spanish Fort, AL

National Provider Directory

National Provider Directory

Locations

10200A Eastern Shore Blvd
Ste A
Spanish Fort, AL 36527
Phone (251) 301-5650

10200A Eastern Shore Blvd
Spanish Fort, AL 36527
Phone (251) 301-5650

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1472083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557792000000",
    "number": "1710433271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10184 EASTERN SHORE BLVD",
            "address_2": "SUITE A",
            "city": "SPANISH FORT",
            "state": "AL",
            "postal_code": "365275814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10184 EASTERN SHORE BLVD",
            "address_2": "SUITE A",
            "city": "SPANISH FORT",
            "state": "AL",
            "postal_code": "365275814",
            "telephone_number": "251-301-5650",
            "fax_number": "251-621-9645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL EYE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-25",
        "last_updated": "2019-05-14",
        "status": "A",
        "authorized_official_last_name": "GROSS",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "251-301-5650",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S486RA041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Perspective Eye Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Perspective Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spanish Fort, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2019; 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.