NPIMap

Organization Active NPI

Central Coast Internal Medicine, P.C.

  • Internal Medicine Physician
  • Newport, OR
National Provider Identifier
1811076896
Registry record updated Apr 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CENTRAL COAST INTERNAL MEDICINE, P.C.
Practice address
775 SW 9TH St
Suite B
Newport, OR 97365-4895
Phone
(541) 265-2007
Fax
(541) 265-3533
NPI assigned
Nov 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2009

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

Authorized official

Name
David C Long, M.D.NPI 1598708455
Title
Owner
Phone
(541) 265-2007

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X OR Primary

Addresses

Primary practice location

775 SW 9TH St
Suite B
Newport, OR 97365-4895

Mailing address

775 SW 9TH St
Suite B
Newport, OR 97365-4895
Phone (541) 265-2007

Other identifiers 2

IdentifierTypeStateIssuer
214437MedicaidOR
CO3602OtherORRR MEDICARE

Other names 1

  • Central Coast Internal Medicine Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239235200000",
    "number": "1811076896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "775 SW 9TH ST",
            "address_2": "SUITE B",
            "city": "NEWPORT",
            "state": "OR",
            "postal_code": "973654895",
            "telephone_number": "541-265-2007",
            "fax_number": "541-265-3533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 SW 9TH ST",
            "address_2": "SUITE B",
            "city": "NEWPORT",
            "state": "OR",
            "postal_code": "973654895",
            "telephone_number": "541-265-2007",
            "fax_number": "541-265-3533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL COAST INTERNAL MEDICINE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2009-04-09",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-265-2007",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "214437",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CO3602",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Coast Internal Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Newport, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2009; 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.