COASTAL CHILDRENS SERVICES PLLC (NPI# 1922356146) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922356146 |
| Entity Type | Organization |
| Organization Name | COASTAL CHILDRENS SERVICES PLLC |
| Practice Address |
120 Memorial Dr Jacksonville NC 28546-6328 |
| Mailing Address |
1915 Glen Meade Rd Wilmington NC 28403-6024 |
| Practice Telephone | 9106676819 |
| Practice Fax Number | 9106674639 |
| Mailing Telephone | 9106675011 |
| Mailing Fax Number | 9107729452 |
| Enumeration Date | 2012-08-20 |
| Last Update Date | 2012-08-20 |
| Authorized Official Name | DR. FERNANDO R. MOYA (PRESIDENT) |
| Authorized Official Telephone | 9106675011 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0206X |
Pediatrics Specialization: Pediatric Gastroenterology |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982092219 | Coastal Childrens Services Pllc | Pediatrics | 2131 S 17th St, Wilmington, NC 28401-7407 | 2015-01-09 |
| 1538558879 | Coastal Childrens Services Pllc | Pediatrics | 2131 S 17th St, Wilmington, NC 28401-7407 | 2015-01-09 |
| 1124371646 | Coastal Childrens Services Pllc | Pediatrics | 400 Liberty Hill Rd, Lumberton, NC 28358-2446 | 2012-10-22 |
| 1548523095 | Coastal Childrens Services Pllc | Pediatrics | 2131 S 17th St, Wilmington, NC 28401-7407 | 2012-06-20 |
| Street Address |
120 MEMORIAL DR |
| City | JACKSONVILLE |
| State | NC |
| Zip Code | 28546-6328 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245238161 | Maria Cristina Soto | Pediatrics | 120 Memorial Dr, Jacksonville, NC 28546-6328 | 2005-07-13 |
| 1578057824 | Samantha Lynn Karle | Nurse Practitioner | 120 Memorial Dr, Jacksonville, NC 28546-6328 | 2018-06-20 |
| 1861882508 | Amanda Sweet | Physician Assistant | 120 Memorial Dr, Jacksonville, NC 28546-6328 | 2015-02-03 |
| 1790183283 | Rosemarie O Wyatt | Nurse Practitioner | 120 Memorial Dr, Jacksonville, NC 28546-6328 | 2014-12-15 |
| 1427450519 | Jenni Clark Floyd | Nurse Practitioner | 120 Memorial Dr, Jacksonville, NC 28546-6328 | 2014-09-19 |
| 1386906204 | Health Sciences Foundation, Inc. | Internal Medicine | 120 Memorial Dr, Jacksonville, NC 28546-6328 | 2012-06-15 |
| 1447556691 | Sue Hartman | Nurse Practitioner | 120 Memorial Dr, Jacksonville, NC 28546-6328 | 2011-02-07 |
| 1689979262 | Christian Lanier Mills | Nurse Practitioner | 120 Memorial Dr, Jacksonville, NC 28546-6328 | 2011-01-13 |
| 1114245594 | Teressa Dana-ione Carter | Social Worker | 120 Memorial Dr, Jacksonville, NC 28546-6328 | 2010-05-11 |
| 1700022449 | Lela Fernandez Hopson | Nurse Practitioner | 120 Memorial Dr, Jacksonville, NC 28546-6328 | 2008-12-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316578388 | Judylyn Hobson | Registered Nurse | Pride In North Carolina, LLC, 3886 Henderson Dr, Jacksonville, NC 28546 | 2020-01-29 |
| 1427694637 | Aaron Patrick Bettcher | Military Health Care Provider | 3rd Mrb Loop Rd, Camp Lejeune, NC 28546 | 2019-11-22 |
| 1962044289 | Levi Scott Marshall | Military Health Care Provider | Everett Creek Road, Building 612, Camp Lejeune, NC 28546 | 2019-10-09 |
| 1649826652 | Nicholas Otazo | Military Health Care Provider | 3rd Mrb 20073, Camp Lejeune, NC 28546 | 2019-08-15 |
| 1417519570 | Publix North Carolina, Lp | Durable Medical Equipment & Medical Supplies | 2001 Marlin Drive Unit 100, Jacksonville, NC 28546 | 2019-06-28 |
| 1023500212 | Josip Ninrodriguez | Military Health Care Provider | 3d Marine Raider Battaliom, Camp Lejeune, NC 28546 | 2018-06-04 |
| 1639661192 | Kenneth Lee Russell | Military Health Care Provider | 3d Marine Raider Battalion, Camp Lejeune, NC 28546 | 2018-05-31 |
| 1346730173 | Coastal Foot Center, LLC | Clinic/Center | 29 Office Park Dr Ste B, Jacksonville, NC 28546 | 2018-05-17 |
| 1578080271 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 380 Western Blvd, Jacksonville, NC 28546 | 2017-08-24 |
| 1144757493 | Darin Lee Peterson | Specialist/Technologist | G644 Camp Geiger, School of Infantry-east, Jacksonville, NC 28546 | 2017-05-17 |
| Find all providers in zip 28546 | ||||
| Taxonomy Code | 2080P0206X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Gastroenterology |
| A pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659422335 | David J Bailey | Pediatrics | 4600 Touchton Rd E, Suite 2500, Jacksonville, FL 32246-8299 | 2007-01-16 |
| 1023531043 | Kelly Marie Summers | Pediatrics | 807 Childrens Way, Jacksonville, FL 32207-8426 | 2017-07-21 |
| 1649430919 | University of Florida Jacksonville Physicians Inc | Pediatrics | 655 W 8th St, Jacksonville, FL 32209-6511 | 2008-06-11 |
| 1124235304 | Jill M Dorsey | Pediatrics | 807 Childrens Way, Nemours Childrens Clinic, Jacksonville, Jacksonville, FL 32207-8426 | 2007-05-17 |
| 1336150861 | Jonathan S. Evans | Pediatrics | 807 Childrens Way, Jacksonville, FL 32207-8426 | 2006-08-10 |
| 1588675011 | Salik Taufiq | Pediatrics | 807 Childrens Way, Jacksonville, FL 32207-8426 | 2006-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841760238 | Mission Community Anesthesiology Specialists LLC | Pediatrics | 2695 Hendersonville Rd Ste 206, Arden, NC 28704-8576 | 2018-11-28 |
| 1205351756 | Dara Adina Seelig | Pediatrics | Brenner Children's Hospital Wake Forest Baptist Health, Winston Salem, NC 27157-0001 | 2017-08-06 |
| 1609229947 | Prathipa Santhanam | Pediatrics | N.c. Children's Hospital, 101 Manning Drive, Chapel Hill, NC 27514 | 2016-07-21 |
| 1912286410 | Carolinas Medical Center-northeast | Pediatrics | 101 East W T Harris Blvd, Bldg 3000, Suite 3301e, Charlotte, NC 28262-7000 | 2011-08-15 |
| 1013296730 | Timothy Menz | Pediatrics | 2711 Randolph Rd Ste 301, Charlotte, NC 28207-2027 | 2011-08-11 |
| 1396904967 | Sachin Shrikar Kunde | Pediatrics | 2601 Lake Dr Ste 201, Raleigh, NC 27607-6689 | 2008-06-08 |
| 1639260243 | Rose Corinne Marcus | Pediatrics | 333 South Columbia Street Cb 7229, Chapel Hill, NC 27599-4202 | 2006-09-27 |
| 1336704766 | Wakemed Specialists Group, LLC | Pediatrics | 23 Sunnybrook Rd, Raleigh, NC 27610-1855 | 2019-05-01 |
| 1982105375 | Pedzfeedz, Pllc | Pediatrics | 720 Saint James Dr, Wilmington, NC 28403 | 2018-02-22 |
| 1013453604 | Novant Medical Group, Inc. | Pediatrics | 11840 Southmore Dr, Suite 200, Charlotte, NC 28277-4466 | 2017-01-06 |
| Find all providers with the same taxonomy | ||||
| City | JACKSONVILLE |
| Zip Code | 28546 |
Please comment or provide details below to improve the information on COASTAL CHILDRENS SERVICES 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.