Organization Active NPI

Shoreline Health, PC

  • Family Medicine Physician
  • Hampstead, NC
National Provider Identifier
1972153724
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SHORELINE HEALTH, PC
Practice address
16150 US Highway 17 Ste C
Hampstead, NC 28443-6302
Phone
(910) 319-9954
Fax
(910) 319-9955
NPI assigned
Sep 13, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Authorized official

Name
David Floyd Hoag II, PA-CNPI 1962478081
Title
President
Phone
(910) 319-9954

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

16150 US Highway 17 Ste C
Hampstead, NC 28443-6302

Mailing address

16150 US Highway 17 Ste C
Hampstead, NC 28443-6302
Phone (910) 319-9954

Other practice location 1

18676 US Highway 17 Ste 1
Hampstead, NC 28443-4050
Phone (910) 319-9954

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200707000122 NC Part B Supplier - Clinic/Group Practice 4183054356 Receives reassigned benefits from 3 practitioners
Practice locations: Hampstead, NC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2172641Shoreline Health, PC16150 US Highway 17 Suite C, Hampstead, NC 28443Certificate of waiverSep 25, 2027

National Provider Directory

National Provider Directory

Locations

18676 US Highway 17
Ste 1
Hampstead, NC 28443
Phone (910) 319-9954

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24567/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1568332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686700800000",
    "number": "1972153724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16150 US HIGHWAY 17 STE C",
            "city": "HAMPSTEAD",
            "state": "NC",
            "postal_code": "284436302",
            "telephone_number": "910-319-9954",
            "fax_number": "910-319-9955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16150 US HIGHWAY 17 STE C",
            "city": "HAMPSTEAD",
            "state": "NC",
            "postal_code": "284436302",
            "telephone_number": "910-319-9954",
            "fax_number": "910-319-9955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18676 US Highway 17 Ste 1",
            "address_purpose": "LOCATION",
            "city": "Hampstead",
            "state": "NC",
            "postal_code": "284434050",
            "country_code": "US",
            "telephone_number": "910-319-9954",
            "fax_number": "910-319-9955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SHORELINE HEALTH, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-13",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A",
        "authorized_official_last_name": "HOAG",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "FLOYD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-319-9954",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampstead, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.