NPIMap

Organization Active NPI

Coastal Carolina Health Care PA

  • Gastroenterology Physician
  • New Bern, NC
National Provider Identifier
1821394800
Registry record updated Feb 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
COASTAL CAROLINA HEALTH CARE PA
Practice address
975 Newman Rd
New Bern, NC 28562-5252
Phone
(252) 514-6644
Fax
(252) 638-2626
NPI assigned
Feb 8, 2011
Last updated
Feb 22, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2023

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

Authorized official

Name
Stephen W. Nuckolls
Title
Ceo
Phone
(252) 514-6685

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X Primary

Addresses

Primary practice location

975 Newman Rd
New Bern, NC 28562-5252

Mailing address

PO Box 12248
New Bern, NC 28561-2248
Phone (252) 514-6644

Other names 1

  • CCHC Endoscopy Center Other name

National Provider Directory

National Provider Directory
Tax ID family
Coastal Carolina Health PA8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1297123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677024000000",
    "number": "1821394800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12248",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285612248",
            "telephone_number": "252-514-6644",
            "fax_number": "252-638-2626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 NEWMAN RD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285625252",
            "telephone_number": "252-514-6644",
            "fax_number": "252-638-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CAROLINA HEALTH CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-08",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A",
        "authorized_official_last_name": "NUCKOLLS",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "252-514-6685"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CCHC Endoscopy Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "CCHC Endoscopy Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in New Bern, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; 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.