NPIMap

Organization Active NPI

James R Forstner

Doing business as Coastal Immediate and Primary

  • Legal Medicine
  • Southport, NC
National Provider Identifier
1912127994
Registry record updated Nov 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
License
21467 Issued in NC
Legal business name
JAMES R FORSTNER
Doing business as
Coastal Immediate and Primary
Practice address
4654 Long Beach Rd SE
Southport, NC 28461-8799
Phone
(910) 457-9564
Fax
(910) 457-6744
NPI assigned
May 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2007

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

Authorized official

Name
Dr. James R Forstner, M.D.
Title
Owner
Phone
(910) 457-9564

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal MedicineGroup: 193400000X SINGLE SPECIALTY GROUP 173000000X 21467 NC Primary

Addresses

Primary practice location

4654 Long Beach Rd SE
Southport, NC 28461-8799

Mailing address

4654 Long Beach Rd SE
Southport, NC 28461-8799
Phone (910) 457-9564

Other names 1

  • COASTAL IMMEDIATE AND PRIMARY Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194998400000",
    "number": "1912127994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4654 LONG BEACH RD SE",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284618799",
            "telephone_number": "910-457-9564",
            "fax_number": "910-457-6744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4654 LONG BEACH RD SE",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284618799",
            "telephone_number": "910-457-9564",
            "fax_number": "910-457-6744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES R FORSTNER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-11-14",
        "status": "A",
        "authorized_official_last_name": "FORSTNER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-457-9564",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Legal Medicine",
            "state": "NC",
            "license": "21467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COASTAL IMMEDIATE AND PRIMARY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Southport, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2007; 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.