Coast Nurse Practitioners, Inc

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R851501 Issued in MS

Legal business name

COAST NURSE PRACTITIONERS, INC

Practice address

13300 RS Kimball Rd
Vancleave, MS 39565-7235

Phone

(228) 826-4600

Fax

(228) 392-8393

NPI assigned

Nov 21, 2007

Last updated

Nov 21, 2007By 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

John M Martin, NPNPI 1962566224

Title

Owner

Phone

(228) 826-4600

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Tax ID family

Coast Nurse Practitioners Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Coast Nurse Practitioners, Inc.

  • Nurse Practitioner
  • Vancleave, MS
  • NPI 1851695720
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Michael Martin, NP

  • Nurse Practitioner
  • Vancleave, MS
  • NPI 1962566224
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1195603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195603200000",
    "number": "1962683623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5386",
            "city": "VANCLEAVE",
            "state": "MS",
            "postal_code": "395655386",
            "telephone_number": "228-826-4600",
            "fax_number": "228-392-8393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13300 RS KIMBALL RD",
            "city": "VANCLEAVE",
            "state": "MS",
            "postal_code": "395657235",
            "telephone_number": "228-826-4600",
            "fax_number": "228-392-8393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COAST NURSE PRACTITIONERS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-21",
        "last_updated": "2007-11-21",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "228-826-4600",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R851501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00126136",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Burnham-McKinney Pharmacy No 4 LLC
• Karen Veronica Carlisle-Bond, FNP-C
• Jake Wallace Carzoli, FNP-C
• Leigh Chiasson
• Karley Clark, APRN, MSN, FNP-C
• Coast Nurse Practitioners, Inc.
• Coastal Family Health Center
• Coastal Family Health Center, Inc (Coastal Family Health Center)
• Coastal Family Health Center, Inc (Coastal Family Health Center, Inc - Vancleave High School Clinic)
• Coastal Family Health Center, Inc (Coastal Family Health Center, Inc - Vancleave Upper Elementary Clinic)

• Family Nurse Practitioner in Vancleave, MS
• Providers in Vancleave, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2007; 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.