Organization Active NPI

Coastal Renal Partners, LLC

  • Nephrology Physician
  • Covington, LA
National Provider Identifier
1821805995
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
COASTAL RENAL PARTNERS, LLC
Practice address
1970 N Highway 190
Covington, LA 70433-5364
Phone
(985) 867-8585
Fax
(985) 867-3644
NPI assigned
Dec 12, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Authorized official

Name
Brandi Willis
Title
Credentialing
Phone
(985) 256-5599

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

1970 N Highway 190
Covington, LA 70433-5364

Mailing address

PO Box 3370
Covington, LA 70434-3370
Phone (985) 867-8585

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1733961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733961600000",
    "number": "1821805995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3370",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704343370",
            "telephone_number": "985-867-8585",
            "fax_number": "985-867-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 N HIGHWAY 190",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704335364",
            "telephone_number": "985-867-8585",
            "fax_number": "985-867-3644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL RENAL PARTNERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-12",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "BRANDI",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "985-256-5599"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; 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.