Coastal Medsurg, Inc.

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Legal business name

COASTAL MEDSURG, INC.

Practice address

1700 Will O Wisp Dr
Virginia Beach, VA 23454-3164

Phone

(757) 496-6400

NPI assigned

Oct 25, 2018

Organization subpart

No

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

Authorized official

Name

Edward Wilson, CSA, RSA

Title

President

Phone

(757) 672-3738

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1540425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540425600000",
    "number": "1861969164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 BISHOP DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234556544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 WILL O WISP DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234543164",
            "telephone_number": "757-496-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL MEDSURG, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-25",
        "last_updated": "2018-10-25",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "757-672-3738",
        "authorized_official_credential": "CSA, RSA"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgical Physician Assistant in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Surgical Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2018; 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.