COASTAL CAROLINA SEDATION ASSOCIATES, LLC (NPI# 1114544996) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114544996 |
| Entity Type | Organization |
| Organization Name | COASTAL CAROLINA SEDATION ASSOCIATES, LLC |
| Practice Address |
5115 Oleander Dr Wilmington NC 28403-7018 |
| Mailing Address |
Po Box 735357 Dallas TX 75373-5006 |
| Practice Telephone | 9103621011 |
| Mailing Telephone | 8883373509 |
| Mailing Fax Number | 9413283997 |
| Enumeration Date | 2020-06-29 |
| Last Update Date | 2020-06-29 |
| Authorized Official Name | JAMES KREGER JR. (MANAGER) |
| Authorized Official Telephone | 2059994132 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207L00000X | Anesthesiology | Allopathic & Osteopathic Physicians | ||
| Y | 367500000X | Nurse Anesthetist, Certified Registered | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
5115 OLEANDER DR |
| City | WILMINGTON |
| State | NC |
| Zip Code | 28403-7018 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316903495 | Wendy M. Landrigan | Physician Assistant | 5115 Oleander Dr, Wilmington, NC 28403-7018 | 2006-04-26 |
| 1396300430 | Marykate Kubler | Physician Assistant | 5115 Oleander Dr, Wilmington, NC 28403-7018 | 2019-05-03 |
| 1508369620 | Rheanna Michelle Mcknight | Physician Assistant | 5115 Oleander Dr, Wilmington, NC 28403-7018 | 2018-03-15 |
| 1942718721 | Kate Logan Wilson | Physician Assistant | 5115 Oleander Dr, Wilmington, NC 28403-7018 | 2018-01-16 |
| 1952785131 | Justin Toth | Physician Assistant | 5115 Oleander Dr, Wilmington, NC 28403-7018 | 2015-07-16 |
| 1912322470 | Taylor Huckabee Thompson | Physician Assistant | 5115 Oleander Dr, Wilmington, NC 28403-7018 | 2014-02-20 |
| 1962748079 | Lisa Leigh Ricci | Physician Assistant | 5115 Oleander Dr, Wilmington, NC 28403-7018 | 2012-12-17 |
| 1497065338 | Kunal Sanjay Dalal | Internal Medicine | 5115 Oleander Dr, Wilmington, NC 28403-7018 | 2010-10-13 |
| 1093023228 | Lesley A. Nevenzel | Physician Assistant | 5115 Oleander Dr, Wilmington, NC 28403-7018 | 2010-09-22 |
| 1528291762 | Sarah Cay Rydock | Physician Assistant | 5115 Oleander Dr, Wilmington, NC 28403-7018 | 2009-09-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902413875 | Ymca of Southeastern Nc | Health Educator | 2710 Market Street, Wilmington, NC 28403 | 2020-09-25 |
| 1659917334 | Noa Alper | Occupational Therapist | 5412 Old Garden Road, Wilmington, NC 28403 | 2019-11-18 |
| 1992346340 | Nancy Rosita Carson | Technician | 5608 Locke Str. Apt 108, Wilmington, NC 28403 | 2019-10-07 |
| 1912484585 | Jennifer Nicole Perry | Behavior Technician | 349 Campus Cv, Wilmington, NC 28403 | 2018-07-25 |
| 1386159929 | Monumental Foundations LLC | Clinic/Center | Plum Tree Plaza 925 South Kerr Ave Suite F4, Wilmington, NC 28403 | 2017-12-05 |
| 1114445731 | Jacqulyn Craichy | Speech-Language Pathologist | 75 Cavalier Drive, Wilmington, NC 28403 | 2017-09-04 |
| 1730638545 | Ashley Mcneil | Durable Medical Equipment & Medical Supplies | 3435 Wilshire Blvd Apt 203, Wilmington, NC 28403 | 2016-09-22 |
| 1306204276 | Valerie Pringle Jones | Physical Therapist | 1717 Shipyard Blvd. Ste 350, Wilmington, NC 28403 | 2016-02-05 |
| 1689039992 | Lifeline Treatment Center | Clinic/Center | 5710 Oleander Dr Ste 100, Wilmington, NC 28403 | 2015-12-31 |
| 1750758264 | Melissa Beatson | Speech-Language Pathologist | 4014 Oleander Drive, Ste. 3b, Coastal Speech & Language Pllc, Wilmington, NC 28403 | 2015-09-01 |
| Find all providers in zip 28403 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588033450 | Amy Landis Formyduval | Nurse Anesthetist, Certified Registered | 6404 Spicewood St, Wilmington, NC 28405-7756 | 2015-09-21 |
| 1942550728 | Bryan Cole Chalk | Nurse Anesthetist, Certified Registered | 2131 S 17th Street, Wilmington, NC 28401 | 2012-09-19 |
| 1316210388 | Anesthesia Care Associates Inc. LLC | Nurse Anesthetist, Certified Registered | 7 Madelyn Ave, Wilmington, DE 19803-3964 | 2012-02-21 |
| 1891020103 | Jessica Lynn Jeffries | Nurse Anesthetist, Certified Registered | 5003 Lady Fern Ct, Wilmington, NC 28409-3976 | 2009-10-05 |
| 1780863068 | John R Shulse | Nurse Anesthetist, Certified Registered | 1602 Physicians Dr Ste 104, Wilmington, NC 28401-7350 | 2007-11-02 |
| 1073652780 | Sharon A Griffith | Nurse Anesthetist, Certified Registered | 807 W Main St, Wilmington, OH 45177-0868 | 2007-02-06 |
| 1073662839 | Paula Kay Lavigne | Nurse Anesthetist, Certified Registered | 1415 Medical Center Dr, Wilmington, NC 28401 | 2007-01-10 |
| 1033142765 | Cynthia Merrell | Nurse Anesthetist, Certified Registered | 2131 South 17th Street, Wilmington, NC 28401 | 2006-07-08 |
| 1902836059 | Ellen Cosby | Nurse Anesthetist, Certified Registered | 2005 Limestone Rd, Suite 5, Wilmington, DE 19808-5505 | 2006-07-04 |
| 1518997626 | Aleen Joy Wilker | Nurse Anesthetist, Certified Registered | 7th and Clayton Sts, 4th Floor Anesthesia, Wilmington, DE 19805 | 2006-07-04 |
| Find all providers in WILMINGTON | ||||
| City | WILMINGTON |
| Zip Code | 28403 |
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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.