NPIMap

Organization Active NPI

Coastal Carolina Chiropractic

Doing business as Coastal Integrative Health

  • Orthopedic Physical Therapist
  • Shallotte, NC
National Provider Identifier
1720497019
Registry record updated Jan 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
P2549 Issued in NC
Legal business name
COASTAL CAROLINA CHIROPRACTIC
Doing business as
Coastal Integrative Health
Practice address
728 Village Rd SW
Shallotte, NC 28470-3412
Phone
(910) 755-5400
Fax
(910) 755-5402
NPI assigned
Aug 12, 2014
Last updated
Jan 30, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2019

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

Authorized official

Name
Dr. Brian Lank, DCNPI 1053599316
Title
Owner
Phone
(910) 755-5400

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
Orthopedic Physical Therapist 2251X0800X P2549 NC Primary

Addresses

Primary practice location

728 Village Rd SW
Shallotte, NC 28470-3412

Mailing address

728 Village Rd SW
Shallotte, NC 28470-3412
Phone (910) 755-5400

Other identifiers 2

IdentifierTypeStateIssuer
7211899MedicaidNC
1821190075OtherNPI

Other names 1

  • Coastal Integrative Health Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Coastal Carolina Chiropractic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

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": "1407801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548806400000",
    "number": "1720497019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "728 VILLAGE RD SW",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284703412",
            "telephone_number": "910-755-5400",
            "fax_number": "910-755-5402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "728 VILLAGE RD SW",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284703412",
            "telephone_number": "910-755-5400",
            "fax_number": "910-755-5402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CAROLINA CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-12",
        "last_updated": "2019-01-30",
        "status": "A",
        "authorized_official_last_name": "LANK",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-755-5400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NC",
            "license": "P2549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7211899",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1821190075",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Integrative Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Coastal Integrative Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shallotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2019; 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.