Coast Orthopedic Center PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME51090 Issued in FL

Legal business name

COAST ORTHOPEDIC CENTER PA

Practice address

1781 Garden St
Titusville, FL 32796-3221

Phone

(321) 269-4300

Fax

(321) 269-7755

NPI assigned

Sep 20, 2006

Last updated

May 24, 2016By 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. James D. Glenn, M.D.NPI 1235101056

Title

Physician

Phone

(321) 269-4300

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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.

• James D Glenn, MD

  • Orthopaedic Surgery Physician
  • Titusville, FL
  • NPI 1235101056
  NPD Authorized official
• Matthew William Loughlin, M.D.

  • Urology Physician
  • The Villages, FL
  • NPI 1255307401
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464048000000",
    "number": "1760580104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1781 GARDEN ST",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327963221",
            "telephone_number": "321-269-4300",
            "fax_number": "321-269-7755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1781 GARDEN ST",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327963221",
            "telephone_number": "321-269-4300",
            "fax_number": "321-269-7755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COAST ORTHOPEDIC CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2016-05-24",
        "status": "A",
        "authorized_official_last_name": "GLENN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "321-269-4300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME51090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046402300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandra Clamon, MS, LPC
• Sydney Clark
• Lisa Jeane Coad
• Coast Dental P.a. (Coast Dental-South Titusville)
• Coast Florida P.a. (Coast Dental-Titusville)
• Coast Physical Therapy, Inc
• Coastal Healthcare Solutions, LLC
• Coastal Pharmacy LLC (East Coast Pharmacy)
• Coastal Pharmacy LLC (East Coast Pharmacy)
• Kristin Nichole Coffrin, ARNP

• Specialist in Titusville, FL
• Providers in Titusville, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2016; 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.