NPIMap

Organization Active NPI

Coastal Rehabilitation Inc

  • Physical Therapist
  • Elizabeth City, NC
National Provider Identifier
1871737874
Registry record updated Sep 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
COASTAL REHABILITATION INC
Practice address
101 Medical Dr
Elizabeth City, NC 27909-3361
Phone
(252) 338-2114
Fax
(252) 338-2115
NPI assigned
Apr 22, 2009
Last updated
Sep 22, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2022

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

Authorized official

Name
Mr. Justyn J Yager, DPTNPI 1124556758
Title
Owner
Phone
(252) 338-2114

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU
Physical Therapist 225100000X NU Primary
Occupational Therapist 225X00000X NU

Addresses

Primary practice location

101 Medical Dr
Elizabeth City, NC 27909-3361

Mailing address

101 Medical Dr
Elizabeth City, NC 27909-3361
Phone (252) 338-2114

Other identifiers 1

IdentifierTypeStateIssuer
7200037MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Coastal Rehab Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1240358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663804800000",
    "number": "1871737874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MEDICAL DR",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279093361",
            "telephone_number": "252-338-2114",
            "fax_number": "252-338-2115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MEDICAL DR",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279093361",
            "telephone_number": "252-338-2114",
            "fax_number": "252-338-2115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL REHABILITATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-22",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A",
        "authorized_official_last_name": "YAGER",
        "authorized_official_first_name": "JUSTYN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-338-2114",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7200037",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth City, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; 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.