EXTENDED CARE PHYSICIANS - COASTAL, PA – NPI #1114191525
Family Medicine

A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.

EXTENDED CARE PHYSICIANS - COASTAL, PA is a provider located in WILMINGTON, NC. NPPES has assigned the NPI number 1114191525 to EXTENDED CARE PHYSICIANS - COASTAL, PA on April 16, 2008. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207QG0300X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine, specializing in Geriatric Medicine Keep in mind, having a taxonomy code selected doesn't replace any credentialing or validation process that may be required by law.

The NPI profile was previously updated about 12 years ago on Mar 19, 2014. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for EXTENDED CARE PHYSICIANS - COASTAL, PA below.

NPI Profile for
EXTENDED CARE PHYSICIANS - COASTAL, PA

NPI Number
1114191525
Enumeration Date

(more than 18 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
EXTENDED CARE PHYSICIANS - COASTAL, PA
Primary location
1013 PORTERS NECK RD
SUITE 130
WILMINGTON, NC 28411-8130
Phone: (910) 795-1471 Fax:
Mailing address
PO BOX 890194
CHARLOTTE, NC 28289-0194
Phone: Fax:
Organization Subpart
No
Authorized Official
ROBIN GLEESON-WARREN
DIRECTOR OF CREDENTIALING
Phone: (828) 210-2678
Updated
Identifiers

Identifiers for EXTENDED CARE PHYSICIANS - COASTAL, PA

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDNC5918852
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.