NPIMap

Organization Active NPI

Coastal Care Management Services LLC

Doing business as Coastal Care Vitality

  • Internal Medicine Physician
  • Savannah, GA
National Provider Identifier
1710869250
Registry record updated Dec 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
COASTAL CARE MANAGEMENT SERVICES LLC
Doing business as
Coastal Care Vitality
Practice address
4 Skidaway Village Walk Ste B
Savannah, GA 31411-2962
Phone
(912) 598-6312
NPI assigned
Jul 24, 2025
Last updated
Dec 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2025

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

Authorized official

Name
Mr. Merlan Powell, CPA
Title
Executive Director
Phone
(912) 598-6312

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X
Women's Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LW0102X

Addresses

Primary practice location

4 Skidaway Village Walk Ste B
Savannah, GA 31411-2962

Mailing address

4 Skidaway Village Walk Ste B
Savannah, GA 31411-2962
Phone (912) 598-6312

Other names 1

  • Coastal Care Vitality Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251201000226 GA Part B Supplier - Clinic/Group Practice 0547753477 Receives reassigned benefits from 3 practitioners
Practice locations: Savannah, GA

National Provider Directory

National Provider Directory

Locations

2 Skidaway Village Walk
Ste C
Savannah, GA 31411

4 Skidaway Village Walk
Ste C
Savannah, GA 31411

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1753315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766102400000",
    "number": "1710869250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 SKIDAWAY VILLAGE WALK STE B",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314112962",
            "telephone_number": "912-598-6312",
            "fax_number": "912-480-9897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 SKIDAWAY VILLAGE WALK STE B",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314112962",
            "telephone_number": "912-598-6312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CARE MANAGEMENT SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-24",
        "last_updated": "2025-12-19",
        "certification_date": "2025-12-19",
        "status": "A",
        "authorized_official_last_name": "POWELL",
        "authorized_official_first_name": "MERLAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "912-598-6312",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Women's Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Care Vitality",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Coastal Care Vitality",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2025; 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.