Organization Active NPI

Coastal Home Care, Inc.

  • Home Health Agency
  • Clearwater, FL
National Provider Identifier
1972565380
Registry record updated Nov 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HHA299991953 Issued in FL
Legal business name
COASTAL HOME CARE, INC.
Practice address
4700 140TH Ave N Ste C102
Clearwater, FL 33762-3846
Phone
(727) 576-2040
Fax
(727) 576-2050
NPI assigned
Apr 3, 2006
Last updated
Nov 6, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2017

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

Authorized official

Name
Mr. Michael Jacob Moses
Title
President
Phone
(727) 638-7638

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HHA299991953 FL Primary

Addresses

Primary practice location

4700 140TH Ave N Ste C102
Clearwater, FL 33762-3846

Mailing address

4700 140TH Ave N Ste C102
Clearwater, FL 33762-3846
Phone (727) 576-2040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory

Locations

4700 140th Ave N
Ste C102
Clearwater, FL 33762
Phone (727) 576-2040

9371 US Highway 19 N
Ste C
Pinellas Park, FL 33782
Phone (727) 576-2040

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Dec 1, 2024 Change of OwnershipThis provider was the seller Patients First Home Care LLCCCN 108109, FL, NPI 1457186975

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

NPI Registry JSON

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509926400000",
    "number": "1972565380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 140TH AVE N STE C102",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337623846",
            "telephone_number": "727-576-2040",
            "fax_number": "727-576-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 140TH AVE N STE C102",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337623846",
            "telephone_number": "727-576-2040",
            "fax_number": "727-576-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL HOME CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-03",
        "last_updated": "2017-11-06",
        "status": "A",
        "authorized_official_last_name": "MOSES",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JACOB",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-638-7638",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "HHA299991953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.