COASTAL CAROLINA NEONATOLOGY, PLLC (NPI# 1144462631) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144462631 |
| Entity Type | Organization |
| Organization Name | COASTAL CAROLINA NEONATOLOGY, PLLC |
| Practice Address |
2131 S 17th St Wilmington NC 28401-7407 |
| Practice Telephone | 9107729202 |
| Practice Fax Number | 9107729452 |
| Mailing Telephone | 9107729202 |
| Mailing Fax Number | 9107729452 |
| Enumeration Date | 2009-03-30 |
| Last Update Date | 2015-10-01 |
| Authorized Official Name | DR. FERNANDO R MOYA (INCORPORATOR) |
| Authorized Official Telephone | 9107729202 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
NC | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649525064 | Coastal Carolina Neonatology, Pllc | Pediatrics | 823 Jefferson St, Whiteville, NC 28472-3703 | 2012-07-23 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | COASTAL CAROLINA NEONATOLOGY, PLLC | 2212 S 17th St, Wilmington, NC 28401-7515 |
| Street Address |
2131 S 17TH ST |
| City | WILMINGTON |
| State | NC |
| Zip Code | 28401-7407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992708747 | Wilmington Anesthesiologists Pllc | Anesthesiology | 2131 S 17th St, Wilmington, NC 28401-7407 | 2005-05-24 |
| 1316548159 | Thomas Martin Leighton | Nurse Practitioner | 2131 S 17th St, Wilmington, NC 28401-7407 | 2020-11-06 |
| 1902406176 | Jeff Marsh | Registered Nurse | 2131 S 17th St, Wilmington, NC 28401-7407 | 2020-10-27 |
| 1629685664 | Bobbie Sheatsley | Nurse Anesthetist, Certified Registered | 2131 S 17th St, Wilmington, NC 28401-7407 | 2020-09-24 |
| 1699393504 | Megan Grogan | Nurse Anesthetist, Certified Registered | 2131 S 17th St, Wilmington, NC 28401-7407 | 2020-07-07 |
| 1215556550 | Salman Khan | Student in an Organized Health Care Education/Training Program | 2131 S 17th St, Wilmington, NC 28401-7407 | 2020-04-15 |
| 1760001028 | John William Miller Jr. | Student in an Organized Health Care Education/Training Program | 2131 S 17th St, Wilmington, NC 28401-7407 | 2020-04-15 |
| 1588283246 | Amanda Kristin Briese | Student in an Organized Health Care Education/Training Program | 2131 S 17th St, Wilmington, NC 28401-7407 | 2020-04-13 |
| 1689293300 | Broc D Astill | Student in an Organized Health Care Education/Training Program | 2131 S 17th St, Wilmington, NC 28401-7407 | 2020-04-13 |
| 1467071423 | Siten Patel | Student in an Organized Health Care Education/Training Program | 2131 S 17th St, Wilmington, NC 28401-7407 | 2020-04-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275002461 | Thrivetothrive, LLC | Physical Therapist | 1606 Physicians Drive, Inside Promina Health, Wilmington, NC 28401 | 2018-11-16 |
| 1841787454 | Kevin Christopher Panebianco | Family Medicine | 1911 S 17th St Ste 130a, Wilmington, NC 28401 | 2018-04-18 |
| 1518472588 | Michelle Bruin | Family Medicine | 415 S. 2nd Street, Wilmington, NC 28401 | 2017-12-12 |
| 1639617343 | Anna Farwell | Behavior Technician | 3904 Oleander Dr. Suite 102, Wilmington, NC 28401 | 2017-02-02 |
| 1588034144 | Dimitri Zivko Pitovski | Allergy & Immunology | 1099 Medical Center Dr Unit 100b, Wilmington, NC 28401 | 2015-09-25 |
| 1629457007 | Megan Havel | Counselor | 1512 E Lakeshore Drive, Wilmington, NC 28401 | 2015-05-19 |
| 1154709251 | Lance Hutchens | Dentist | 1611 Doctors Cir, Wilmington, NC 28401 | 2015-05-11 |
| 1609281161 | Diane Pittman Whitford | Counselor | 313 Walnut St., Wilmington, NC 28401 | 2014-06-24 |
| 1942550728 | Bryan Cole Chalk | Nurse Anesthetist, Certified Registered | 2131 S 17th Street, Wilmington, NC 28401 | 2012-09-19 |
| 1740566546 | Valerie Baars | Pharmacist | 2302 S 17th Street, Wilmington, NC 28401 | 2011-10-25 |
| Find all providers in zip 28401 | ||||
| Taxonomy Code | 2080N0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neonatal-Perinatal Medicine |
| A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518202969 | Ronald Paul Gregoire | Pediatrics | 207 Cabbage Inlet Ln, Wilmington, NC 28409-3004 | 2012-12-11 |
| 1902210180 | Brian Barnette | Pediatrics | 1600 Rockland Rd, Wilmington, DE 19803-3607 | 2014-06-16 |
| 1346583689 | Gina Marie Fong | Pediatrics | 1600 Rockland Rd, Wilmington, DE 19803 | 2013-04-05 |
| 1114206737 | Aaron Jefthy T. Yee | Pediatrics | 1600 Rockland Rd, Wilmington, DE 19803-3607 | 2011-08-13 |
| 1184866659 | Deepthi Alapati | Pediatrics | 1600 Rockland Road, Wilmington, DE 19803-3607 | 2009-03-30 |
| 1003058561 | Joanna Costa | Pediatrics | 1600 Rockland Rd, Wilmington, DE 19803-3607 | 2009-03-30 |
| 1245433275 | Julia D. Ryan | Pediatrics | 1600 Rockland Rd, Wilmington, DE 19803-3607 | 2007-06-07 |
| 1184761223 | Carol Brumbalow Andersen | Pediatrics | 1600 Rockland Rd, Wilmington, DE 19803-3607 | 2007-01-30 |
| 1265533871 | Mohamed H Sharaf | Pediatrics | 2131 S 17th St, Wilmington, NC 28401-7407 | 2006-09-26 |
| 1477654598 | Mark T. Ogino | Pediatrics | 1600 Rockland Rd, Wilmington, DE 19803-3607 | 2006-09-25 |
| Find all providers in WILMINGTON | ||||
| City | WILMINGTON |
| Zip Code | 28401 |
Please comment or provide details below to improve the information on COASTAL CAROLINA NEONATOLOGY, 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.