NPIMap

Organization Active NPI

Coastal Horizons Center, Inc.

  • Community/Behavioral Health Agency
  • Wilmington, NC
National Provider Identifier
1922022607
Registry record updated Jul 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
MHL-065-011 Issued in NC
Legal business name
COASTAL HORIZONS CENTER, INC.
Practice address
615 Shipyard Blvd
Wilmington, NC 28412-6431
Phone
(910) 790-0187
Fax
(910) 790-0189
NPI assigned
Jul 27, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Ms. Margaret Weller Stargell
Title
President & Ceo
Phone
(910) 790-0187

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Practitioners 95

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

View all 95

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20080429000046 NC Part B Supplier - Clinic/Group Practice 9739267964 Receives reassigned benefits from 89 practitioners
5 other NPIs on this enrollment
Practice locations: Burgaw, NC; Rocky Point, NC; Shallotte, NC; Wilmington, NC

National Provider Directory

National Provider Directory

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MHL-065-011 NC Primary
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X MHL-065-011 NC

Addresses

NPPES NPI Registry

Primary practice location

615 Shipyard Blvd
Wilmington, NC 28412-6431

Mailing address

615 Shipyard Blvd
Wilmington, NC 28412-6431
Phone (910) 790-0187

Other identifiers 12

NPPES NPI Registry
IdentifierTypeStateIssuer
8300416BMedicaidNC
5900561MedicaidNC
8300416MedicaidNC
8301322GMedicaidNC
8300416QMedicaidNC
8300416TMedicaidNC
6005343MedicaidNC
8300416HMedicaidNC
8301322HMedicaidNC
8301322MedicaidNC
8300416GMedicaidNC
8301322BMedicaidNC

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 28, 2014.

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406505600000",
    "number": "1922022607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 SHIPYARD BLVD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284126431",
            "telephone_number": "910-790-0187",
            "fax_number": "910-790-0189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 SHIPYARD BLVD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284126431",
            "telephone_number": "910-790-0187",
            "fax_number": "910-790-0189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL HORIZONS CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2014-07-28",
        "status": "A",
        "authorized_official_last_name": "STARGELL",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_middle_name": "WELLER",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "910-790-0187",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "MHL-065-011",
            "primary": true
        },
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "NC",
            "license": "MHL-065-011",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300416B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5900561",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300416",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301322G",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300416Q",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300416T",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005343",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300416H",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301322H",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301322",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300416G",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301322B",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jul 28, 2014; 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.