COASTAL CAROLINA PSYCHIATRIC SERVICES PLLC (NPI# 1598807430) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598807430 |
| Entity Type | Organization |
| Organization Name | COASTAL CAROLINA PSYCHIATRIC SERVICES PLLC |
| Practice Address |
1708 Lakeside Dr Nw Wilson NC 27896-1800 |
| Practice Telephone | 2522659680 |
| Practice Fax Number | 2522659680 |
| Mailing Telephone | 2522659680 |
| Mailing Fax Number | 2522659680 |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. BUSH KAVURU (MEMBER-MANAGER) |
| Authorized Official Telephone | 2522659680 |
| Authorized Official Credential | M.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| Street Address |
1708 LAKESIDE DR NW |
| City | WILSON |
| State | NC |
| Zip Code | 27896-1800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528543972 | Realo Discount Drug Stores of Eastern North Carolina, Inc | Durable Medical Equipment & Medical Supplies | 3724 Raleigh Road Parkway, Suite A, Wilson, NC 27896 | 2018-10-02 |
| 1518450865 | Alysann Brooke Price | Social Worker | 5878 Farmwood Loop, Wilson, NC 27896 | 2018-06-12 |
| 1144744517 | Sara Lynn Campbell | Physical Therapist | 3200 Nash Street North, Wilson, NC 27896 | 2017-07-27 |
| 1902327109 | Lamont Zebediah Barnett | Counselor | 3904 Airport Drive, Wilson, NC 27896 | 2017-06-28 |
| 1578014718 | Kristy Kaye Rowland | Counselor | 3707 Marion Court N, Wilson, NC 27896 | 2016-10-24 |
| 1780058057 | Marsha Ricketts Harper | Occupational Therapy Assistant | 3105 Senior Village Lane, Wilson, NC 27896 | 2015-11-24 |
| 1508122615 | Charlotte Hurt | Social Worker | 910 Raleigh Rd Parkway, Wilson, NC 27896 | 2012-04-03 |
| 1447542139 | Sarah Elizabeth Kirby Bischoff | Pharmacist | 3401 Raleigh Rd, Harris Teeter, Wilson, NC 27896 | 2011-05-12 |
| 1235462342 | Wilson Medical Group | Non-Pharmacy Dispensing Site | 3302 Nash St North, Wilson, NC 27896 | 2009-09-09 |
| 1164662466 | My Friend's House, LLC | Community Based Residential Treatment Facility, Mental Illness | 3607 Columbia Avenue, Wilson, NC 27896 | 2009-02-26 |
| Find all providers in zip 27896 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366729048 | Redesigning Life of N.c.,ll | Clinic/Center | 806 Tarboro St W, Suite A, Wilson, NC 27893-4771 | 2011-11-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215537436 | Amazing Love | Clinic/Center | 1201 W Crowell St, Monroe, NC 28112-4535 | 2020-10-27 |
| 1629677547 | Julia Kaplinska, Phd, Pllc | Clinic/Center | 4908 Vistawood Way, Durham, NC 27713-8065 | 2020-10-21 |
| 1013514587 | Lisa Johnson Reid | Clinic/Center | 3491 Evans St Ste B, Greenville, NC 27834-4534 | 2020-10-07 |
| 1609473230 | Chadwick Counseling, Pllc | Clinic/Center | 105 Chelsea Cir, Beaufort, NC 28516-9001 | 2020-10-06 |
| 1275146946 | Lakeisha Ward | Clinic/Center | 2221 W Raleigh Blvd Ste 117, Rocky Mount, NC 27803-2745 | 2020-08-24 |
| 1417570995 | Sb Psychiatry Pllc | Clinic/Center | 55 Vilcom Center Dr Ste 230, Chapel Hill, NC 27514-1690 | 2020-05-19 |
| 1467082396 | Premier Service of Carolina, Inc | Clinic/Center | 2020 Remount Rd Ste 105, Gastonia, NC 28054-7478 | 2020-01-20 |
| 1417598962 | Limitless Living Counseling & Consulting, Pllc | Clinic/Center | 806 Fairmont St, Greensboro, NC 27401-1723 | 2019-10-07 |
| 1598316770 | Renaissance Healthcare Group Raleigh, LLC | Clinic/Center | 7300 Carmel Executive Park Dr Ste 100, Charlotte, NC 28226-1307 | 2019-09-27 |
| 1255981627 | Each One Teach Two | Clinic/Center | 401 Hawthorne Ln Ste 110-224, Charlotte, NC 28204-2484 | 2019-09-17 |
| Find all providers with the same taxonomy | ||||
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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.