Coastal Pain Care PA

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

Legal business name

COASTAL PAIN CARE PA

Practice address

755 N 11TH St
Suite P2280
Beaumont, TX 77702-1501

Phone

(409) 892-4600

Fax

(409) 892-4605

NPI assigned

Nov 21, 2005

Organization subpart

No

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

Authorized official

Name

Craig A Charleston, MD

Title

Owner

Phone

(409) 892-4600

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FJBIAD

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kimberly Andrews Bordelon, CRNA

  • Certified Registered Nurse Anesthetist
  • Houston, TX
  • NPI 1750619615
  NPD (past)

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312243200000",
    "number": "1891778171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 N 11TH ST",
            "address_2": "SUITE P2280",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021501",
            "telephone_number": "409-892-4600",
            "fax_number": "409-892-4605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 N 11TH ST",
            "address_2": "SUITE P2280",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021501",
            "telephone_number": "409-892-4600",
            "fax_number": "409-892-4605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL PAIN CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-21",
        "last_updated": "2011-08-02",
        "status": "A",
        "authorized_official_last_name": "CHARLESTON",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "409-892-4600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175364201",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0027MW",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madison Ashley Cline, MS SLP-CCC
• Clinkscales Dental
• John Charles Clinkscales Jr., D.D.S.
• Coastal Home Health Inc
• Coastal Imaging Associates, PLLC
• Coastal Spine & Pain Institute, PLLC
• Cynthia Lynn Coats, R.N.
• Cobb Family Chiropractic PLLC
• Michele Erin Cobb, D.C.
• Judith Ann Cobbett, D.D.S.

• Interventional Pain Medicine Physician in Beaumont, TX
• Providers in Beaumont, TX by specialty
• Interventional Pain Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2011; 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.