COASTLINE MEDICAL, INC. (NPI# 1902176563) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902176563 |
| Entity Type | Organization |
| Organization Name | COASTLINE MEDICAL, INC. |
| Practice Address |
509 Viking Dr Ste E Virginia Beach VA 23452-7323 |
| Practice Telephone | 7572758050 |
| Practice Fax Number | 8886005328 |
| Mailing Telephone | 7572758050 |
| Mailing Fax Number | 8886005328 |
| Enumeration Date | 2012-01-12 |
| Last Update Date | 2020-06-10 |
| Authorized Official Name | JAMES MICHAEL RAY (PRESIDENT) |
| Authorized Official Telephone | 7572758050 |
| Authorized Official Credential | CFO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | COASTLINE MEDICAL, INC. | 509 Viking Dr Suite E, Virginia Beach, VA 23452-7323 |
| Street Address |
509 VIKING DR STE E |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23452-7323 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417436965 | Steven C Franklin | Pedorthist | 509 Viking Dr Ste E, Virginia Beach, VA 23452-7323 | 2018-08-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881208650 | Tracie Marie Romero | Counselor | 236 Mustag Trail Ste, Virginia Beach, VA 23452 | 2020-08-31 |
| 1346884400 | Asra R Javeed Dmd PC | Dentist | 4312 Holland Rd Ste 108, Virginia Beach, VA 23452 | 2019-11-01 |
| 1598313298 | Reach Orthotic & Prosthetic Service, Inc. | Prosthetic/Orthotic Supplier | 397 Little Neck Rd, Building 3400, Suite 107, Virginia Beach, VA 23452 | 2019-08-27 |
| 1205483229 | Brenna Dober | Behavior Technician | 380 Clevend Place, Virginia Beach, VA 23452 | 2019-08-23 |
| 1639652977 | Jessica Keefe | Psychologist | 642 Carriage Hill Road, Virginia Beach, VA 23452 | 2018-09-12 |
| 1316433709 | Circle of Life, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3630 S Plaza Trl Ste 210a, Virginia Beach, VA 23452 | 2018-07-09 |
| 1992205165 | Jeremy Monsanto | Behavior Technician | 629 Phoenix Drive, Ste 150, Virginia Beach, VA 23452 | 2018-02-14 |
| 1174056014 | Samantha Brown | Behavior Technician | 780 Nnhaven Parkway, Suite 400, Virginia Beach, VA 23452 | 2017-04-07 |
| 1043757685 | Join1,llc | Home Health | 349 Southport Circle, Suite 106, Virginia Beach, VA 23452 | 2017-01-20 |
| 1720520620 | Renee Brush | Psychologist | 485 S Independence Blvd Ste 104, Virginia Beach, VA 23452 | 2016-11-08 |
| Find all providers in zip 23452 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598313298 | Reach Orthotic & Prosthetic Service, Inc. | Prosthetic/Orthotic Supplier | 397 Little Neck Rd, Building 3400, Suite 107, Virginia Beach, VA 23452 | 2019-08-27 |
| 1437605003 | Coastal Prosthetics and Orthotics,llc | Prosthetic/Orthotic Supplier | 1924 Landstown Centre Way Ste 109, Box # 13 for Mail, Virginia Beach, VA 23456-1624 | 2016-09-01 |
| 1215260062 | Rehab Specialists, Inc. | Prosthetic/Orthotic Supplier | 2005 Harvest Moon Ct., Virginia Beach, VA 23453-6675 | 2009-09-11 |
| 1417130055 | Victoria Marie Graziano | Prosthetic/Orthotic Supplier | 277 N Lynnhaven Rd, Suite 108, Virginia Beach, VA 23452-6963 | 2007-12-05 |
| 1457551236 | Branne LLC | Prosthetic/Orthotic Supplier | 5262 Fairfield Shopping Ctr, Virginia Beach, VA 23464-4212 | 2007-07-20 |
| 1326069477 | Healthy Feet Inc | Prosthetic/Orthotic Supplier | 3500 Virginia Beach Blvd Ste 100, Virginia Beach, VA 23452-4445 | 2006-07-22 |
| 1508821117 | Montagnas Shoes Inc | Prosthetic/Orthotic Supplier | 752 Independence Blvd, Montagnas Shoes, Virginia Beach, VA 23455 | 2006-04-18 |
| 1124006713 | Progressive Prosthetic & Orthopedic Services, Inc. | Prosthetic/Orthotic Supplier | 380 Cleveland Pl, Virginia Beach, VA 23462-6529 | 2006-01-04 |
| 1386270643 | Coastal Prosthetics and Orthotics, LLC | Prosthetic/Orthotic Supplier | 1008 First Colonial Rd, Virginia Beach, VA 23454-3071 | 2020-03-19 |
| 1447523261 | Mid-atlantic Bracing, Inc. | Prosthetic/Orthotic Supplier | 4445 Corporation Ln, Virginia Beach, VA 23462-3262 | 2012-02-10 |
| Find all providers in VIRGINIA BEACH | ||||
| City | VIRGINIA BEACH |
| Zip Code | 23452 |
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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.