Coastal Medical and Wellness PLLC
Organization Active NPI Urgent Care Clinic/Center · Hubert, NC
NPI 1740057017 · NPPES record last updated Sep 22, 2024
Key facts
- NPI
- 1740057017
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Urgent Care Clinic/Center 261QU0200X
- Legal business name
- COASTAL MEDICAL AND WELLNESS PLLC
- Practice address
- 1537 Freedom Way Ste 2
Hubert, NC 28539-3647 - Phone
- (910) 238-4268
- Fax
- (910) 238-4397
- NPI assigned
- Dec 7, 2023
- Organization subpart
- No
Authorized official
- Name
- Veronika Surber, PA-C
- Title
- Owner
- Phone
- (252) 647-1616
Practitioners 6
-
Rachel Ames, PA-C
-
Veronika Ann Surber, PA C
-
Rachel Caroline Jones, PA-C
-
Maria E Crespo, D.O.
-
Kaitlin Rose Walter, PA-C
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 34D2296690 | Coastal Medical and Wellness PLLC | Certificate of waiver | Jan 3, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240506003589 | NC | Part B Supplier - Clinic/Group Practice | 2567802689 |
Receives reassigned benefits from 4 practitioners Practice locations: Hubert, NC |
National Provider Directory
Locations
1537 Freedom Way
Ste 2
Hubert, NC 28539
Phone (910) 238-4268
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urgent Care Clinic/Center | 261QU0200X | Yes |
Addresses
Primary practice location
1537 Freedom Way Ste 2
Hubert, NC 28539-3647
Mailing address
1537 Freedom Way Ste 2
Hubert, NC 28539-3647
Phone (910) 238-4268
Other names
- Coastal Medical and Wellness
Other providers in Hubert, NC
- Jervie May Bergado Calubaquib
- Carobell, Inc.
- Carobell, Inc.
- Carobell, Inc.
- Joseph Armand Clairmont Jr.
- Shirley Katherine Coates
- Bethany Joy Cobbs
- Courageous Counseling & Wellness, PLLC
- Jessica Cox
- Tammy L Crocker
All providers in Hubert, NC · Urgent Care Clinic/Center in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.