COASTAL CAROLINA HEALTH CARE, PA (NPI# 1891282638) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891282638 |
| Entity Type | Organization |
| Organization Name | COASTAL CAROLINA HEALTH CARE, PA |
| Other Organization Name | CCHC HAVELOCK PRIMARY CARE |
| Practice Address |
1224 E Main St Havelock NC 28532-2405 |
| Mailing Address |
Po Box 12248 New Bern NC 28561-2248 |
| Practice Telephone | 2524477474 |
| Mailing Telephone | 2525146685 |
| Enumeration Date | 2018-04-17 |
| Last Update Date | 2018-04-17 |
| Authorized Official Name | STEPHEN NUCKOLLS (CEO) |
| Authorized Official Telephone | 2525146685 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| CCHC HAVELOCK PRIMARY CARE | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184278335 | Coastal Carolina Health Care, Pa | Podiatrist | 1421 S Glenburnie Rd # D, New Bern, NC 28562-2603 | 2019-07-26 |
| 1255662052 | Coastal Carolina Health Care, Pa | Psychiatry & Neurology | 2861 Trent Rd, New Bern, NC 28562-2029 | 2010-01-19 |
| Street Address |
1224 E MAIN ST |
| City | HAVELOCK |
| State | NC |
| Zip Code | 28532-2405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952397101 | William Graham Evans Jr. | Physician Assistant | 1224 E Main St, Havelock, NC 28532-2405 | 2005-09-23 |
| 1245789379 | Radonna Carroll | Nurse Practitioner | 1224 E Main St, Havelock, NC 28532-2405 | 2016-09-30 |
| 1851784185 | Constance Hall | Nurse Practitioner | 1224 E Main St, Havelock, NC 28532-2405 | 2015-03-11 |
| 1194161380 | Quicker Care Clinic Pa | Emergency Medicine | 1224 E Main St, Havelock, NC 28532-2405 | 2013-05-15 |
| 1639489966 | Elizabeth Dawn Burnette | Registered Nurse | 1224 E Main St, Havelock, NC 28532-2405 | 2010-10-20 |
| 1891783056 | Jean Basnight | Family Medicine | 1224 E Main St, Havelock, NC 28532 | 2005-10-12 |
| 1083600720 | Beachcare Urgent Medical Care Center of Havelock | Clinic/Center | 1224 E Main St, Havelock, NC 28532-2405 | 2005-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194341396 | Tara-dawm R Tootle | Pharmacist | 1204 E Mail St, Havelock, NC 28532 | 2020-06-23 |
| 1194377903 | Jessy Eugene Warren Whittall | Military Health Care Provider | 4389 Beafort Rd, Havelock, NC 28532 | 2019-07-11 |
| 1508375676 | Lacey Leeann Robinson | Dentist | 610 Miller Boulevard, Havelock, NC 28532 | 2017-09-21 |
| 1053861112 | Adam Toliver Davis | Dentist | 502 Us Hwy 70 West, Havelock, NC 28532 | 2016-10-12 |
| 1467825331 | Stephany Agudelo | Social Worker | 102 Verona Dive, Havelock, NC 28532 | 2015-11-02 |
| 1386089225 | Joanna Tiaira Johnson | Nurse Practitioner | 4389 Beaufort, Havelock, NC 28532 | 2013-05-06 |
| 1962665653 | Coastal Childrens Clinic | Pediatrics | 218 Stone Bridge Square, Havelock, NC 28532 | 2008-07-03 |
| 1235325218 | Michelle Land Amber | Dietitian, Registered | 210 Stonebridge Square, Havelock, NC 28532 | 2007-09-24 |
| 1437217213 | Havelock Chiropractic Center P.a. | Chiropractor | 314 Highway 70 West, Havelock, NC 28532 | 2006-12-05 |
| 1831273127 | David Lee Woodward Jr. | Chiropractor | 314 Hwy. 70 West, Havelock, NC 28532 | 2006-10-24 |
| Find all providers in zip 28532 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881129021 | Samuel Ward | Family Medicine | 4389 Beaufort Rd, Havelock, NC 28532 | 2017-04-25 |
| 1932632767 | Kyle Herring | Family Medicine | 4389 Beaufort Rd, Havelock, NC 28562 | 2017-04-08 |
| 1679916340 | Jeannette Marielle Mcintyre | Family Medicine | 4389 Beaufort Rd, Havelock, NC 28532 | 2013-04-12 |
| 1538177100 | Simon O'regan | Family Medicine | 532 Webb Blvd, Havelock, NC 28532-2042 | 2006-08-03 |
| 1730117110 | William Crawford | Family Medicine | 532 Webb Blvd, Havelock, NC 28532-2042 | 2006-06-28 |
| 1891783056 | Jean Basnight | Family Medicine | 1224 E Main St, Havelock, NC 28532 | 2005-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710586581 | Fhpg, LLC | Family Medicine | 1690 Us Highway 1 S Ste 200, Southern Pines, NC 28387-7037 | 2020-10-22 |
| 1225637333 | Mcpc-8, LLC | Family Medicine | 3110 S Horner Blvd Ste 4&5, Sanford, NC 27332-8212 | 2020-10-20 |
| 1740889864 | Mcpc-8, LLC | Family Medicine | 1690 Us Highway 1 S Ste 100, Southern Pines, NC 28387-7037 | 2020-10-20 |
| 1851999882 | Integrative Wellness Partners, Inc | Family Medicine | 3555 Hansa Dr, Castle Hayne, NC 28429-5863 | 2020-10-12 |
| 1124625504 | Tiffany Anne Swanson | Family Medicine | 405 Climax St, Graham, NC 27253-1608 | 2020-10-08 |
| 1235745985 | Alegis Care - North Carolina PC | Family Medicine | 11016 Rushmore Dr Ste 300, Charlotte, NC 28277-3651 | 2020-09-18 |
| 1902411077 | Carolina Medical Partners Pllc | Family Medicine | 10535 Flennigan Way, Charlotte, NC 28277-1417 | 2020-09-15 |
| 1558975433 | Kerr Area Rural Medical Alliance Pllc | Family Medicine | 266 Raymond Tharrington Rd, Louisburg, NC 27549-9687 | 2020-09-08 |
| 1083226906 | Relymd Medical Group Nc, Pllc | Family Medicine | 212 S Tryon St Ste 1000, Charlotte, NC 28281-0001 | 2020-08-21 |
| 1184233884 | Brittany Joyce Mcneil | Family Medicine | 1010 S 16th St, Wilmington, NC 28401-8018 | 2020-07-28 |
| Find all providers with the same taxonomy | ||||
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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.