COASTAL OB GYN AND INFERTILITY (NPI# 1356531396) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356531396 |
| Entity Type | Organization |
| Organization Name | COASTAL OB GYN AND INFERTILITY |
| Practice Address |
114a Memorial Dr Jacksonville NC 28546-6328 |
| Mailing Address |
7121 Spid Suite 302 Corpus Christi TX 78412 |
| Practice Telephone | 3618515000 |
| Mailing Telephone | 3618515000 |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2007-07-26 |
| Authorized Official Name | THERESSA JAMES NOWITZKY (OWNER) |
| Authorized Official Telephone | 3618515000 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 36540 | NC | Allopathic & Osteopathic Physicians |
| Street Address |
114A MEMORIAL DR |
| City | JACKSONVILLE |
| State | NC |
| Zip Code | 28546-6328 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891025763 | Patricia Stark | Nurse Practitioner | 114a Memorial Dr, Jacksonville, NC 28546-6328 | 2009-12-28 |
| 1306017165 | Breakthrough Services Inc. | Preferred Provider Organization | 114a Memorial Dr, Jacksonville, NC 28546-6328 | 2008-03-19 |
| 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 | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396108528 | Michelle Melanson | Obstetrics & Gynecology | 14546 Old Saint Augustine Rd Ste 305-311, Jacksonville, FL 32258-5468 | 2016-04-04 |
| 1316387947 | Alexander David Raw | Obstetrics & Gynecology | 1600 W Walnut St Bldg 3, Jacksonville, IL 62650-1136 | 2013-06-27 |
| 1912260613 | Paulami Guha | Obstetrics & Gynecology | 836 Prudential Dr Ste 1600, Jacksonville, FL 32207 | 2012-06-19 |
| 1689963696 | Dawn M Mormak | Obstetrics & Gynecology | 836 Prudential Dr Ste 1506, Jacksonville, FL 32207-8342 | 2011-03-30 |
| 1710210745 | Niamh A Condon | Obstetrics & Gynecology | 653-1 W 8th St # L-17, Jacksonville, FL 32209-6511 | 2009-09-09 |
| 1871614057 | Aida A. Malonzo | Obstetrics & Gynecology | 1512 Palm Ave, Jacksonville, FL 32207-2916 | 2007-04-03 |
| 1487717864 | Geoffrey Gillen | Obstetrics & Gynecology | 653 W 8th St # L17, Jacksonville, FL 32209-6511 | 2006-12-18 |
| 1306916580 | Jason R Thompson | Obstetrics & Gynecology | 6885 Belfort Oaks Place Ste 210, Jacksonville, FL 32216 | 2006-11-08 |
| 1154400554 | Charles Burk | Obstetrics & Gynecology | 203 Nacogdoches St Ste 210, Jacksonville, TX 75766-2455 | 2006-11-04 |
| 1295826295 | Henry Solomon Haye | Obstetrics & Gynecology | Onslow Women's Health Center, 291 Huff Drive, Jacksonville, NC 28546 | 2006-09-27 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 28546 |
Please comment or provide details below to improve the information on COASTAL OB GYN AND INFERTILITY.
| 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.