Individual provider Active NPI

Corah Edwards-Seale, FNP-C

  • Family Nurse Practitioner
  • Jacksonville, NC
National Provider Identifier
1790591907
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5021252 Issued in NC
Practice address
2145 Country Club Rd Ste 500
Jacksonville, NC 28546-2404
Phone
(910) 353-0565
NPI assigned
Dec 4, 2024
Last updated
Dec 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5021252 NC Primary

Addresses

Primary practice location

2145 Country Club Rd Ste 500
Jacksonville, NC 28546-2404

Mailing address

107 Settlers Way
Hampstead, NC 28443-6802

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250102000889 NC Practitioner - Nurse Practitioner 0648707646 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastline Family Medicine, PLLCGroup PAC ID 2961811831, 5 clinicians

Practice addresses (Care Compare)

2145 Country Club Rd
Suite 500
Jacksonville, NC 28546-2404
Phone (910) 353-0565

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5021252NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Coastline Family Medicine PLLC CurrentSince Dec 4, 2024 Accepting new patients

Locations

2145 Country Club Rd
Ste 500
Jacksonville, NC 28546
Phone (910) 352-1969

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1733270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1790591907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 SETTLERS WAY",
            "city": "HAMPSTEAD",
            "state": "NC",
            "postal_code": "284436802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2145 COUNTRY CLUB RD STE 500",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285462404",
            "telephone_number": "910-353-0565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS-SEALE",
        "first_name": "CORAH",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-04",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5021252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

Verify at the official NPI Registry.