Coastline Spine Chiropractic & Rehab, PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

COASTLINE SPINE CHIROPRACTIC & REHAB, PLLC

Practice address

900 State Road 16 Ste 2
St Augustine, FL 32084-6567

Phone

(904) 599-7791

NPI assigned

Aug 26, 2021

Last updated

Jan 11, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. William Beasley, D.C.NPI 1548723273

Title

Owner

Phone

(904) 599-7791

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

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.

• William Levi Beasley, DC

  • Chiropractor
  • St Augustine, FL
  • NPI 1548723273
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1629936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736553600000",
    "number": "1750058889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 STATE ROAD 16 STE 2",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320846567",
            "telephone_number": "904-599-7791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 STATE ROAD 16 STE 2",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320846567",
            "telephone_number": "904-599-7791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTLINE SPINE CHIROPRACTIC & REHAB, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-26",
        "last_updated": "2025-01-11",
        "certification_date": "2025-01-11",
        "status": "A",
        "authorized_official_last_name": "BEASLEY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-599-7791",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.