NPIMap

Organization Active NPI

Coastal Carolina Health Care PA

Doing business as CCHC Atlantic Primary Care

  • Family Medicine Physician
  • New Bern, NC
National Provider Identifier
1861446346
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
COASTAL CAROLINA HEALTH CARE PA
Doing business as
CCHC Atlantic Primary Care
Practice address
730 Newman Rd
New Bern, NC 28562-5238
Phone
(252) 634-9090
Fax
(252) 634-9915
NPI assigned
May 20, 2006
Last updated
Feb 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Authorized official

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

730 Newman Rd
New Bern, NC 28562-5238

Mailing address

PO Box 12248
New Bern, NC 28561-2248
Phone (252) 634-9090

Other names 1

  • CCHC Atlantic Primary Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031230000224 NC Part B Supplier - Clinic/Group Practice 9739087693 Receives reassigned benefits from 137 practitioners
23 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: New Bern, NC; Morehead City, NC; Havelock, NC; Bayboro, NC

Other NPIs on the same Medicare enrollment 18

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 18

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.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706745600000",
    "number": "1861446346",
    "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": "252-634-9090",
            "fax_number": "252-634-9915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 NEWMAN RD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285625238",
            "telephone_number": "252-634-9090",
            "fax_number": "252-634-9915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CAROLINA HEALTH CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A",
        "authorized_official_last_name": "NUCKOLLS",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "252-514-6685",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CCHC Atlantic Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.