Coastline Medical, Inc.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

COASTLINE MEDICAL, INC.

Practice address

509 Viking Dr Ste E
Virginia Beach, VA 23452-7323

Phone

(757) 275-8050

Fax

(888) 600-5328

NPI assigned

Jan 12, 2012

Organization subpart

No

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

Authorized official

Name

James Michael Ray, CFONPI 1558641258

Title

President

Phone

(757) 275-8050

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 5

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

• James Michael Ray, CFO

  • Orthotic Fitter
  • Virginia Beach, VA
  • NPI 1558641258
  NPD Authorized official
• Steven C Franklin, CPED

  • Pedorthist
  • Virginia Beach, VA
  • NPI 1417436965
  NPD
• Sandra Montoya, CPO

  • Pedorthist
  • Virginia Beach, VA
  • NPI 1639982150
  NPD
• Elizabeth Marie Nicklaus, CPO

  • Orthotist
  • Virginia Beach, VA
  • NPI 1710736780
  NPD
• Lorrin Avery Herbert, CFO

  • Orthotic Fitter
  • Virginia Beach, VA
  • NPI 1952866659
  NPD (past)

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

{
    "created_epoch": "1326326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701216000000",
    "number": "1902176563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 VIKING DR STE E",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234527323",
            "telephone_number": "757-275-8050",
            "fax_number": "888-600-5328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 VIKING DR STE E",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234527323",
            "telephone_number": "757-275-8050",
            "fax_number": "888-600-5328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTLINE MEDICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-12",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A",
        "authorized_official_last_name": "RAY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "757-275-8050",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coastal Virginia Mental Health Services PLLC
• Coastal Virginia Oral and Maxillofacial Surgery, PC
• Coastal Virginia Psychological Associates
• Coastal Virginia Psychological Associates
• Coastal Virginia Spine and Pain Center LLC
• Delene Coates
• Mikel E Coates, IDC
• Emma Grace Coats
• Takeyra Coats, CTRS
• Jessica Kayli Cobb

• Prosthetic/Orthotic Supplier in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Prosthetic/Orthotic Supplier in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; 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.