Coastal Headache Clinic PLLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

COASTAL HEADACHE CLINIC PLLC

Practice address

1715 Country Club Rd Ste B
Jacksonville, NC 28546-6042

Phone

(910) 238-2050

NPI assigned

Mar 3, 2022

Organization subpart

No

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

Authorized official

Name

Terra Kamp, FNPNPI 1083079701

Title

President

Phone

(614) 571-4245

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Practitioners 4

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

• Terra Lynn Kamp, NP-C

  • Nurse Practitioner
  • Jacksonville, NC
  • NPI 1083079701
  Medicare reassignment Care Compare group NPD Authorized official
• Bonnie Frank, NP

  • Family Nurse Practitioner
  • Jacksonville, NC
  • NPI 1740948330
  Medicare reassignment Care Compare group NPD
• Jennifer Schofield, FNP-BC

  • Family Nurse Practitioner
  • Jacksonville, NC
  • NPI 1235727264
  Medicare reassignment Care Compare group NPD
• Angela G Biggs, FNP

  • Family Nurse Practitioner
  • Jacksonville, NC
  • NPI 1790449023
  Medicare reassignment NPD

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

{
    "created_epoch": "1646265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663372800000",
    "number": "1760139323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 COUNTRY CLUB RD STE B",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466042",
            "telephone_number": "910-238-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 COUNTRY CLUB RD STE B",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466042",
            "telephone_number": "910-238-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL HEADACHE CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-03",
        "last_updated": "2022-09-17",
        "certification_date": "2022-09-17",
        "status": "A",
        "authorized_official_last_name": "KAMP",
        "authorized_official_first_name": "TERRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "614-571-4245",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coastal Childrens Services, PLLC
• Coastal Community Services, LLC
• Coastal Diagnostic Imaging, PLLC
• Coastal Foot Center
• Coastal Foot Center, LLC
• Coastal Horizons Center Inc.
• Coastal Massage and Wellness
• Coastal Mobile Medical Doctor, PA
• Coastal Nephrology, P.a.
• Coastal Neurotherapy, P.a.

• Nurse Practitioner in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2022; 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.