Coastal Chiropractic Clinic
Organization Active NPI Clinic/Center · Yulee, FL
NPI 1831966381 · NPPES record last updated Dec 5, 2023
Key facts
- NPI
- 1831966381
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- COASTAL CHIROPRACTIC CLINIC
- Practice address
- 464073 State Road 200 Ste 4
Yulee, FL 32097-6307 - Phone
- (904) 780-5050
- NPI assigned
- Dec 5, 2023
- Organization subpart
- No
Authorized official
- Name
- Dr. James Joseph Zielenski, DC
- Title
- Manager
- Phone
- (732) 977-8869
Practitioners 1
-
James Joseph Zielenski, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240117003549 | FL | Part B Supplier - Clinic/Group Practice | 5698127421 |
Receives reassigned benefits from 1 practitioner Practice locations: Yulee, FL |
National Provider Directory
Locations
464073 State Road 200
Ste 4
Yulee, FL 32097
Phone (904) 491-1345
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Yes |
Addresses
Primary practice location
464073 State Road 200 Ste 4
Yulee, FL 32097-6307
Mailing address
95126 Gladiolus PL
Fernandina Beach, FL 32034-0035
Phone (732) 977-8869
Other providers in Yulee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 5, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.