CRYSTAL COAST PAIN MANAGEMENT CENTER, PLLC (NPI# 1013401561) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013401561 |
| Entity Type | Organization |
| Organization Name | CRYSTAL COAST PAIN MANAGEMENT CENTER, PLLC |
| Practice Address |
57 Office Park Dr Jacksonville NC 28546 |
| Mailing Address |
2111 Neuse Blvd Ste J New Bern NC 28560-4318 |
| Practice Telephone | 2526360300 |
| Mailing Telephone | 1252636030 |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2020-10-26 |
| Authorized Official Name | RACHEL LOOK (PRACTICE MANAGER) |
| Authorized Official Telephone | 2526360300 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093209546 | Crystal Coast Pain Management Center, Pllc | Anesthesiology | 5053 Executive Dr Ste B, Morehead City, NC 28557 | 2018-06-19 |
| 1790747988 | Crystal Coast Pain Management Center, Pllc | Anesthesiology | 2111 Neuse Blvd. Suite J, New Bern, NC 28560 | 2006-04-04 |
| Street Address |
57 OFFICE PARK DR |
| City | JACKSONVILLE |
| State | NC |
| Zip Code | 28546 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801058789 | Lechris Health Systems of Jacksonville, Inc. | Community/Behavioral Health | 57 Office Park Dr, Jacksonville, NC 28546-7327 | 2008-07-01 |
| 1568930527 | April Thomas | Physician Assistant | 57 Office Park Dr, Jacksonville, NC 28546 | 2018-11-08 |
| 1992179782 | Lechris Couseling Services | Clinic/Center | 57 Office Park Dr, Jacksonville, NC 28546-7327 | 2015-11-17 |
| 1275936668 | Tara Robinson | Counselor | 57 Office Park Dr, Jacksonville, NC 28546-7327 | 2014-09-30 |
| 1487992483 | Elizabeth Connelly Morris | Counselor | 57 Office Park Dr, Jacksonville, NC 28546-7327 | 2013-01-25 |
| 1699039537 | Tracey Suggs | Counselor | 57 Office Park Dr, Jacksonville, NC 28546-7327 | 2012-06-26 |
| 1528345790 | Elizabeth Crockett Henderson | Counselor | 57 Office Park Dr, Jacksonville, NC 28546-7327 | 2011-11-15 |
| 1083904387 | Lechris Health Systems of Jacksonville, Inc. | Psychiatry & Neurology | 57 Office Park Dr, Jacksonville, NC 28546-7327 | 2011-04-08 |
| 1659673184 | Jeremy B Seamon | Counselor | 57 Office Park Dr, Jacksonville, NC 28546-7327 | 2010-12-04 |
| 1891002267 | Jaime D Sheppard | Counselor | 57 Office Park Dr, Jacksonville, NC 28546-7327 | 2010-09-08 |
| 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 | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| 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 Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306351432 | Carteret Surgical Associates P.a. | Anesthesiology | 2145 Country Club Rd Ste 400, Jacksonville, NC 28546-2400 | 2017-12-12 |
| 1467896241 | Christopher Mark Sirianni | Anesthesiology | 2026 S Jackson St Apt 1213, Jacksonville, TX 75766 | 2013-04-23 |
| 1316179245 | Advanced Pain Management Clinic, LLC | Anesthesiology | 5757 Booth Road, Bldg 100, Jacksonville, FL 32207 | 2009-08-11 |
| 1639297328 | Reynaldo Pardo | Anesthesiology | 12078 San Jose Blvd Ste 2, Jacksonville, FL 32223-8671 | 2007-03-27 |
| 1144378514 | Cesar A Gorospe | Anesthesiology | 7240 San Pedro Rd, Jacksonville, FL 32217-3408 | 2007-01-08 |
| 1104922541 | Orlando Garay Florete Jr. | Anesthesiology | 4131 University Blvd S Ste 12, Jacksonville, FL 32216-4352 | 2006-09-15 |
| 1497711733 | Metropolitan Pain Management | Anesthesiology | 4063 Salisbury Road North, Suite 206, Jacksonville, FL 32216 | 2006-04-25 |
| 1639140866 | Patrick James Burns | Anesthesiology | 2700 Riverside Ave Ste 2, Jacksonville, FL 32205 | 2006-01-27 |
| 1912978149 | Christopher Roberts | Anesthesiology | 10475 Centurion Pkwy N Ste 201, Jacksonville, FL 32256-5004 | 2006-01-27 |
| 1144290677 | Jerry Richard Foltz II | Anesthesiology | 4796 Hodges Blvd, Suite 101-104, Jacksonville, FL 32224 | 2006-01-26 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 28546 |
Please comment or provide details below to improve the information on CRYSTAL COAST PAIN MANAGEMENT CENTER, 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.