COASTAL PEDIATRIC ASSOCIATES, PLLC (NPI# 1447638341) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447638341 |
| Entity Type | Organization |
| Organization Name | COASTAL PEDIATRIC ASSOCIATES, PLLC |
| Practice Address |
3505 Converse Dr Suite 200 Wilmington NC 28403-6131 |
| Practice Telephone | 9103925634 |
| Practice Fax Number | 9107772022 |
| Mailing Telephone | 9103925634 |
| Mailing Fax Number | 9107772022 |
| Enumeration Date | 2015-05-12 |
| Last Update Date | 2015-05-12 |
| Authorized Official Name | DR. THOMAS BLACKSTONE (MANAGING MEMBER) |
| Authorized Official Telephone | 9102028020 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 17469 | NC | Other Service Providers |
| Street Address |
3505 CONVERSE DR SUITE 200 |
| City | WILMINGTON |
| State | NC |
| Zip Code | 28403-6131 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073532248 | Dimock Weinberg & Cherry Dds Pllc | Dentist | 3505 Converse Dr, Suite 175, Wilmington, NC 28403-6131 | 2006-07-19 |
| 1225524473 | Michelle Espinoza | Behavioral Analyst | 3505 Converse Dr, Wilmington, NC 28403-6131 | 2018-07-10 |
| 1821519125 | Ashley Jill Koehler | Occupational Therapist | 3505 Converse Dr, Wilmington, NC 28403-6131 | 2017-06-28 |
| 1760865760 | Kidzcare Pediatrics, PC | Pediatrics | 3505 Converse Dr, Suite 200, Wilmington, NC 28403-6131 | 2015-07-08 |
| 1891194015 | Raleigh Durham Medical Group, Pa | Pediatrics | 3505 Converse Dr, Ste 200, Wilmington, NC 28403-6131 | 2014-08-14 |
| 1821327768 | Shannon Dee Keely | Registered Nurse | 3505 Converse Dr, Suite 200, Wilmington, NC 28403-6131 | 2009-12-23 |
| 1861628695 | Breony Miller Vinson | Physician Assistant | 3505 Converse Dr, Suite 200, Wilmington, NC 28403-6131 | 2009-06-08 |
| 1588898571 | Whitney Nugent King | Pediatrics | 3505 Converse Dr, Suite 200, Wilmington, NC 28403-6131 | 2009-05-06 |
| 1740342112 | Shawn Marie Desmond | Nurse Practitioner | 3505 Converse Dr, Suite 200, Wilmington, NC 28403-6131 | 2006-12-14 |
| 1912094301 | Thomas L Blackstone | Pediatrics | 3505 Converse Dr, Ste 200, Wilmington, NC 28403-6132 | 2006-10-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902413875 | Ymca of Southeastern Nc | Health Educator | 2710 Market Street, Wilmington, NC 28403 | 2020-09-25 |
| 1659917334 | Noa Alper | Occupational Therapist | 5412 Old Garden Road, Wilmington, NC 28403 | 2019-11-18 |
| 1992346340 | Nancy Rosita Carson | Technician | 5608 Locke Str. Apt 108, Wilmington, NC 28403 | 2019-10-07 |
| 1912484585 | Jennifer Nicole Perry | Behavior Technician | 349 Campus Cv, Wilmington, NC 28403 | 2018-07-25 |
| 1386159929 | Monumental Foundations LLC | Clinic/Center | Plum Tree Plaza 925 South Kerr Ave Suite F4, Wilmington, NC 28403 | 2017-12-05 |
| 1114445731 | Jacqulyn Craichy | Speech-Language Pathologist | 75 Cavalier Drive, Wilmington, NC 28403 | 2017-09-04 |
| 1730638545 | Ashley Mcneil | Durable Medical Equipment & Medical Supplies | 3435 Wilshire Blvd Apt 203, Wilmington, NC 28403 | 2016-09-22 |
| 1306204276 | Valerie Pringle Jones | Physical Therapist | 1717 Shipyard Blvd. Ste 350, Wilmington, NC 28403 | 2016-02-05 |
| 1689039992 | Lifeline Treatment Center | Clinic/Center | 5710 Oleander Dr Ste 100, Wilmington, NC 28403 | 2015-12-31 |
| 1750758264 | Melissa Beatson | Speech-Language Pathologist | 4014 Oleander Drive, Ste. 3b, Coastal Speech & Language Pllc, Wilmington, NC 28403 | 2015-09-01 |
| Find all providers in zip 28403 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790396703 | Jermaine Cannon | Specialist | 1 Murphy Rd, Wilmington, DE 19803-3044 | 2020-08-13 |
| 1467986778 | Sharrie Hanley | Specialist | 4701 Wrightsville Ave Bldg 1e2, Wilmington, NC 28403-6912 | 2017-04-13 |
| 1952843948 | Beyond Basics Salons Inc | Specialist | 1124 Floral Pkwy, Wilmington, NC 28403-6212 | 2016-11-08 |
| 1225586324 | Yay Ot 4 Kids, LLC | Specialist | 305 N 15th St, Wilmington, NC 28401-3813 | 2016-09-17 |
| 1053869511 | Kay Eileen Shoemaker | Specialist | 107 Florence Ave, Wilmington, DE 19803-2337 | 2016-09-13 |
| 1487000758 | Vamano Inc | Specialist | 5231 W Woodmill Dr, Suite 45, Wilmington, DE 19808-4068 | 2016-05-05 |
| 1689031262 | Ivps of Delaware | Specialist | 1305 Kirkwood Highway, Wilmington, DE 19805 | 2016-01-27 |
| 1548646490 | Delvalley Healthcare LLC | Specialist | 2055 Limestone Rd Ste 201, Wilmington, DE 19808-5536 | 2015-08-03 |
| 1194123117 | Bharat Shah | Specialist | 166 Landis Way N, Wilmington, DE 19803-6408 | 2014-12-08 |
| 1477955748 | Amberly Tokoly | Specialist | 1717 Shipyard Blvd Ste 320, Wilmington, NC 28403-8019 | 2014-09-18 |
| Find all providers in WILMINGTON | ||||
| City | WILMINGTON |
| Zip Code | 28403 |
Please comment or provide details below to improve the information on COASTAL PEDIATRIC ASSOCIATES, PLLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.