NPIMap

Organization Active NPI

Raleigh Durham Medical Group, PA

Doing business as Coastal Pediatric Associates

  • Pediatrics Physician
  • Wilmington, NC
National Provider Identifier
1891194015
Registry record updated Jan 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
RALEIGH DURHAM MEDICAL GROUP, PA
Doing business as
Coastal Pediatric Associates
Practice address
3505 Converse Dr
Ste 200
Wilmington, NC 28403-6131
Phone
(910) 392-5634
Fax
(910) 392-5654
NPI assigned
Aug 14, 2014
Last updated
Jan 28, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
RALEIGH DURHAM MEDICAL GROUP, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 28, 2015

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

Authorized official

Name
David Moye
Title
Executive Director
Phone
(919) 851-2174

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X Primary

Addresses

Primary practice location

3505 Converse Dr
Ste 200
Wilmington, NC 28403-6131

Mailing address

5420 Wade Park Blvd
Ste 106
Raleigh, NC 27607-4188
Phone (919) 233-5952

Other names 1

  • Coastal Pediatric Associates Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Raleigh Durham Medical Group PA66 organizations share this tax ID, including this one
Part of
Raleigh Durham Medical Group PA

Organizations with this tax ID in the same state 18

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1407974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422403200000",
    "number": "1891194015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5420 WADE PARK BLVD",
            "address_2": "STE 106",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276074188",
            "telephone_number": "919-233-5952",
            "fax_number": "919-854-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 CONVERSE DR",
            "address_2": "STE 200",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036131",
            "telephone_number": "910-392-5634",
            "fax_number": "910-392-5654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RALEIGH DURHAM MEDICAL GROUP, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RALEIGH DURHAM MEDICAL GROUP, PA",
        "enumeration_date": "2014-08-14",
        "last_updated": "2015-01-28",
        "status": "A",
        "authorized_official_last_name": "MOYE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "919-851-2174"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Pediatric Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2015; 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.