Coastal Orthopedics and Sports Medicine of Southwest Florida P.a.

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

COASTAL ORTHOPEDICS AND SPORTS MEDICINE OF SOUTHWEST FLORIDA P.A.

Doing business as

Coastal Physical Therapy

Practice address

8000 State Road 64 E
Bradenton, FL 34212-7703

Phone

(941) 792-1404

Fax

(941) 794-1863

NPI assigned

Dec 13, 2006

Last updated

Feb 10, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nancy R Borggren

Title

Credentialing Surpervisor

Phone

(941) 782-0102

Specialties & licenses 10

Addresses

Other names 1

• Coastal Physical Therapy Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

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

• Coastal Orthopedics & Sports Medicine of Southwest Florida PA

  • Orthopaedic Surgery Physician
  • Bradenton, FL
  • NPI 1285740720

  O20100930058239

  Same enrollment

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739145600000",
    "number": "1942361522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8000 STATE ROAD 64 E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342127703",
            "telephone_number": "941-792-1404",
            "fax_number": "941-794-1863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8000 STATE ROAD 64 E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342127703",
            "telephone_number": "941-792-1404",
            "fax_number": "941-794-1863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL ORTHOPEDICS AND SPORTS MEDICINE OF SOUTHWEST FLORIDA P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A",
        "authorized_official_last_name": "BORGGREN",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CREDENTIALING SURPERVISOR",
        "authorized_official_telephone_number": "941-782-0102"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225000000X",
            "taxonomy_group": "",
            "desc": "Orthotic Fitter",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2251H1200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Hand",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Coastal Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Thomas William Clyburn III, PH.D.
• Coastal Anesthesia Providers, LLC
• Coastal Cardiovascular Consultants PLLC
• Coastal Orthopedics & Sports Medicine of Southwest FL, PA
• Coastal Orthopedics & Sports Medicine of Southwest Florida PA
• Coastal Practice Management LLC
• Coastal Senior Healthcare Inc
• Claire Gene Coats, PA-C
• Nathan Jay Coblentz
• Kristie Virginia Cochran, LMHC

• Physical Therapist in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; 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.