Coastal ER IV LLC

Primary specialty

Emergency Care Clinic/CenterTaxonomy code 261QE0002X

License

H8172 Issued in TX

Legal business name

COASTAL ER IV LLC

Practice address

7750 South Padre Island Drive
Corpus Christi, TX 78412

Phone

(361) 994-1911

NPI assigned

Mar 1, 2016

Organization subpart

No

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

Authorized official

Name

David Kenyon, MD

Title

Director

Phone

(361) 994-1911

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1456790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704931200000",
    "number": "1922468156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7750 SOUTH PADRE ISLAND DRIVE",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "78412",
            "telephone_number": "361-994-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7750 SOUTH PADRE ISLAND DRIVE",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "78412",
            "telephone_number": "361-994-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL ER IV LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-01",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A",
        "authorized_official_last_name": "KENYON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "361-994-1911",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": "TX",
            "license": "H8172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "H8172",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Coastal Counseling Services, LLC
• Coastal ER I, LLC
• Coastal ER II, LLC
• Coastal ER V, LLC
• Coastal Family Medicine Associates, PA
• Coastal First Assisting LLC
• Coastal Living, Inc.
• Coastal Living, Inc.

• Emergency Care Clinic/Center in Corpus Christi, TX
• Providers in Corpus Christi, TX by specialty
• Emergency Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2024; 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.