COASTAL CAROLINA HEALTH CARE PA (NPI# 1528623790) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528623790 |
| Entity Type | Organization |
| Organization Name | COASTAL CAROLINA HEALTH CARE PA |
| Other Organization Name | CCHC EXTENDED CARE |
| Practice Address |
1040 Medical Park Ave New Bern NC 28562-5248 |
| Mailing Address |
Po Box 12248 New Bern NC 28561-2248 |
| Practice Telephone | 2526382273 |
| Practice Fax Number | 2526331403 |
| Mailing Telephone | 2525146685 |
| Mailing Fax Number | 2525142745 |
| Enumeration Date | 2019-05-03 |
| Last Update Date | 2020-01-09 |
| Authorized Official Name | STEPHEN W. NUCKOLLS (CEO) |
| Authorized Official Telephone | 2525146685 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208M00000X | Hospitalist | Allopathic & Osteopathic Physicians | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| CCHC EXTENDED CARE | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750567970 | Coastal Carolina Health Care Pa | Clinic/Center | 1020 Medical Park Avenue, New Bern, NC 28562-5248 | 2008-01-17 |
| 1447290010 | Coastal Carolina Health Care Pa | Clinic/Center | 1030 Medical Park Ave, New Bern, NC 28562-5248 | 2006-06-08 |
| 1306885975 | Coastal Carolina Health Care Pa | Clinic/Center | 1010 Medical Park Ave, New Bern, NC 28562-5248 | 2006-06-06 |
| 1386194397 | Coastal Carolina Health Care Pa | Clinic/Center | 901 Broad St, Oriental, NC 28571-9783 | 2016-10-13 |
| 1063962074 | Coastal Carolina Health Care Pa | Clinic/Center | 606 Main St, Bayboro, NC 28515-9632 | 2016-10-13 |
| 1073911822 | Coastal Carolina Health Care Pa | Clinic/Center | 108 Market St, New Bern, NC 28560-6704 | 2014-12-10 |
| 1477992501 | Coastal Carolina Health Care Pa | Internal Medicine | 941 Newman Rd, New Bern, NC 28562-5252 | 2013-06-21 |
| 1821394800 | Coastal Carolina Health Care Pa | Internal Medicine | 975 Newman Rd, New Bern, NC 28562-5252 | 2011-02-08 |
| 1780623207 | Coastal Carolina Health Care Pa | Clinic/Center | 702 Newman Rd, New Bern, NC 28562-5238 | 2006-06-06 |
| 1225077746 | Coastal Carolina Health Care Pa | Clinic/Center | 3252 Wellons Blvd, New Bern, NC 28562-5234 | 2006-06-06 |
| Street Address |
1040 MEDICAL PARK AVE |
| City | NEW BERN |
| State | NC |
| Zip Code | 28562-5248 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528050424 | Luke A Elliott | Family Medicine | 1040 Medical Park Ave, New Bern, NC 28562-5248 | 2005-08-17 |
| 1851912299 | Erica Jane Bencivenga | Registered Nurse | 1040 Medical Park Ave, New Bern, NC 28562-5248 | 2020-04-27 |
| 1851948590 | Yvette Clark Moleta | Nurse Practitioner | 1040 Medical Park Ave, New Bern, NC 28562-5248 | 2019-08-19 |
| 1346806650 | Sandra Christine Morehouse | Registered Nurse | 1040 Medical Park Ave, New Bern, NC 28562-5248 | 2019-05-13 |
| 1043749120 | Felicia C Holston | Nurse Practitioner | 1040 Medical Park Ave, New Bern, NC 28562-5248 | 2017-06-12 |
| 1790146256 | Lauren Wardrop Miller | Physician Assistant | 1040 Medical Park Ave, New Bern, NC 28562-5248 | 2016-03-11 |
| 1619336211 | April L Vandall | Nurse Practitioner | 1040 Medical Park Ave, New Bern, NC 28562-5248 | 2016-02-11 |
| 1255710331 | Samuel Jackson Dail | Family Medicine | 1040 Medical Park Ave, New Bern, NC 28562 | 2015-05-22 |
| 1982023941 | Paula Marie Foreman | Physician Assistant | 1040 Medical Park Ave, New Bern, NC 28562 | 2014-04-07 |
| 1447509252 | Elisabeth B Boelman | Physician Assistant | 1040 Medical Park Ave, New Bern, NC 28562-5248 | 2012-09-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235741943 | Benchmark Physical Therapy of Nc, LLC | Occupational Therapist | 2026 Waterscape Way Ste 13, New Bern, NC 28562 | 2020-08-24 |
| 1023677234 | Katie Rebecca Masters Dmd Pllc | Dentist | 2900 Doctor M L K Jr. Blvd, New Bern, NC 28562 | 2019-06-11 |
| 1093281750 | Try-care LLC | Mechanotherapist | 37 Shoreline Dr, New Bern, NC 28562 | 2018-10-22 |
| 1376021949 | Maykin Kimberly Boyd | Social Worker | 1405 A South Glenburnie Rd, New Bern, NC 28562 | 2018-08-05 |
| 1770069288 | Rebecca Ann Anderson Bright | Counselor | 3435 Belmont Blvd, New Bern, NC 28562 | 2018-07-17 |
| 1841799814 | Dallin Page | Physical Therapist | 2111 Neuse Blvd Suite K, New Bern, NC 28562 | 2018-02-06 |
| 1467960476 | Randolph Ntoko Esabe | Pharmacist | 258 Station House Rd, New Bern, NC 28562 | 2018-01-12 |
| 1881100568 | Reid Family Eye Care, Od, Pllc | Optometrist | 3105 Doctor M.l.k. Jr. Blvd, New Bern, NC 28562 | 2017-12-18 |
| 1851742050 | Harris Teeter, LLC | Durable Medical Equipment & Medical Supplies | 2032 Waterscape Way, New Bern, NC 28562 | 2016-06-29 |
| 1609241868 | Victor Montoyaamaya | Military Health Care Provider | 3331 Hardee Farms Dr, New Bern, NC 28562 | 2015-12-14 |
| Find all providers in zip 28562 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477781805 | Charles Anuju Fotuchang | Internal Medicine | 2000 Nouse Blvd, New Bern, NC 28560 | 2009-06-24 |
| 1124211669 | Ideal Health Care Pllc | Internal Medicine | 200 Castle Ridge Rd, New Bern, NC 28562-7384 | 2007-08-17 |
| 1063467264 | Craig Mathew Zavelo | Internal Medicine | 670 Cardinal Place, New Bern, NC 28562-5201 | 2006-05-24 |
| 1568417764 | Ronald Allyn Preston | Internal Medicine | 1020 Medical Park Ave, New Bern, NC 28562-5248 | 2006-05-24 |
| 1639140775 | Kevin Michael French | Internal Medicine | 670 Cardinal Rd, New Bern, NC 28562-5201 | 2006-01-27 |
| 1780678532 | Paul J Healy | Internal Medicine | 2604 Dr. Martin Luther King Jr. Blvd., New Bern, NC 28562-4238 | 2005-09-08 |
| 1356334627 | Elizabeth A Benson | Internal Medicine | 730 Newman Rd, New Bern, NC 28562-5238 | 2005-08-23 |
| 1528451036 | Edward Covington Erwin | Internal Medicine | 2000 Neuse Blvd, New Bern, NC 28560 | 2015-03-08 |
| 1134549108 | Diana Andreea Gliga | Internal Medicine | 2604 Dr Martin Luther King Jr Blvd, New Bern, NC 28562-4238 | 2014-04-17 |
| 1679912117 | Jeffrey De Jesus Maldonado Pena | Internal Medicine | 970 Newman Rd, New Bern, NC 28562-5200 | 2013-06-18 |
| Find all providers in NEW BERN | ||||
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| 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.