Coastal Pulmonary Medicine PA

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

Legal business name

COASTAL PULMONARY MEDICINE PA

Practice address

1090 Medical Center Dr
Wilmington, NC 28401-7353

Phone

(910) 343-3345

Fax

(910) 343-1924

NPI assigned

Dec 5, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Trace Griffin

Title

Practice Manager

Phone

(910) 662-8550

Specialties & licenses 3

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554336000000",
    "number": "1851375794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 MEDICAL CENTER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017353",
            "telephone_number": "910-343-3345",
            "fax_number": "910-343-1924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 MEDICAL CENTER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017353",
            "telephone_number": "910-343-3345",
            "fax_number": "910-343-1924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL PULMONARY MEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-05",
        "last_updated": "2019-04-04",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "TRACE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "910-662-8550",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NC",
            "license": null,
            "primary": true
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8901272",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC GROUP NUMBER",
            "identifier": "01272",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pulmonary Disease Physician in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Pulmonary Disease Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2019; 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.