COASTAL FAMILY HEALTH CENTER, INC. (NPI# 1629309117) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629309117 |
| Entity Type | Organization |
| Organization Name | COASTAL FAMILY HEALTH CENTER, INC. |
| Other Organization Name | COASTAL FAMIL HEALTH CENTER, D'IBERVILLE CLINIC |
| Practice Address |
3446 Big Ridge Rd Diberville MS 39540-2421 |
| Mailing Address |
Po Box 475 Biloxi MS 39533-0475 |
| Practice Telephone | 2283742494 |
| Mailing Telephone | 2283742494 |
| Enumeration Date | 2010-01-22 |
| Last Update Date | 2010-01-22 |
| Authorized Official Name | MR. JOE M DAWSEY (CEO) |
| Authorized Official Telephone | 2283742494 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Coastal Famil Health Center, D'Iberville Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427364397 | Coastal Family Health Center, Inc. | Clinic/Center | 1408 44th Ave, Gulfport, MS 39501-2554 | 2010-08-30 |
| 1508897000 | Coastal Family Health Center, Inc. | Clinic/Center | 4913 Weems Street, Moss Point, MS 39563 | 2006-07-05 |
| 1801102793 | Coastal Family Health Center, Inc. | Clinic/Center | 257 Davis Ave Ste A, Pass Christian, MS 39571-4541 | 2010-08-30 |
| 1740417922 | Coastal Family Health Center, Inc. | Pharmacy | 1025 Division St, Ste A, Biloxi, MS 39530-2906 | 2009-06-16 |
| 1679581599 | Coastal Family Health Center, Inc. | Clinic/Center | 4770 Amoco Dr, Moss Point, MS 39563-9627 | 2006-08-04 |
| 1841220357 | Coastal Family Health Center, Inc. | Clinic/Center | 15024 Martin Luther King Jr Blvd, Gulfport, MS 39503 | 2006-07-03 |
| Street Address |
3446 BIG RIDGE RD |
| City | DIBERVILLE |
| State | MS |
| Zip Code | 39540-2421 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073144333 | Boqin Hu | Nurse Practitioner | 3446 Big Ridge Rd, Diberville, MS 39540-2421 | 2020-01-27 |
| 1366912529 | Carissa Bolden | Nurse Practitioner | 3446 Big Ridge Rd, Diberville, MS 39540-2421 | 2018-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528347531 | Lindsey Rachelle Cuevas | Pharmacist | 10551 D'iberville Blvd, D'iberville, MS 39540 | 2011-08-08 |
| 1750438255 | Andrea L Davis | Dentist | 11505 Cinema Drive, Suite 6, D'iberville, MS 39540 | 2007-01-05 |
| 1750308250 | South Mississippi Urgent Care | Clinic/Center | 3661 Sangani Blvd, Suite E, Dlberville, MS 39540 | 2006-07-17 |
| 1568948016 | Courtney Leigh Ponder | Nurse Practitioner | 11516 Lamey Bridge Rd Ste I, Diberville, MS 39540 | 2018-07-18 |
| 1134635360 | Southern Regional Chiropractic and Rehabilitation Center | Nurse Practitioner | 11505 Cinema Dr Ste 7, Diberville, MS 39540 | 2017-12-26 |
| 1487177481 | Walgreen Co | Pharmacy | 4031 Popps Ferry Rd Ste A, Diberville, MS 39540 | 2017-07-21 |
| 1891151817 | Total Renal Care Inc | Clinic/Center | 3200 Mallett Rd, Ste F, Diberville, MS 39540 | 2016-01-06 |
| 1679944763 | Katelyn Elizabeth Martin | Behavioral Analyst | 4061 Suzanne Dr, Diberville, MS 39540 | 2015-10-14 |
| 1467880922 | Carla Diane Diffenderfer | Nurse Practitioner | 11516 Lamey Bridge Rd Ste I, Diberville, MS 39540 | 2013-10-21 |
| 1982618369 | Becky F Hollibaugh | Family Medicine | 3920 Promenade Pkwy, Biloxi, MS 39540 | 2006-07-28 |
| Find all providers in zip 39540 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871193722 | Coastal Family Health Center, Inc | Clinic/Center | 12424 Highway 57, Vancleave, MS 39565-8608 | 2020-10-29 |
| 1992305445 | Coastal Family Health Center, Inc | Clinic/Center | 5500 Hurley Wade Rd, Moss Point, MS 39562-8548 | 2020-10-26 |
| 1841890399 | Coastal Family Health Center, Inc | Clinic/Center | 10700 Yellow Jacket Rd, Ocean Springs, MS 39564-8038 | 2020-10-26 |
| 1033755343 | Access Family Health Services, Inc. | Clinic/Center | 179 Mullen Ave, Nettleton, MS 38858-6033 | 2019-11-21 |
| 1285280180 | Delta Health Center, Inc | Clinic/Center | 506 Washington Avenue, Moorhead, MS 38761 | 2019-08-15 |
| 1265088421 | Delta Health Center, Inc | Clinic/Center | 400 South Blvd, Drew, MS 38737-3508 | 2019-08-14 |
| 1215583356 | Delta Health Center, Inc. | Clinic/Center | 302 College Ave, Indianola, MS 38751-2112 | 2019-08-14 |
| 1063068252 | Delta Health Center, Inc | Clinic/Center | 1101 Oak St, Inverness, MS 38753-8725 | 2019-08-13 |
| 1750937959 | Delta Health Center, Inc | Clinic/Center | 212 E Claiborne St, Sunflower, MS 38778-9640 | 2019-08-13 |
| 1750937108 | Delta Health Center, Inc | Clinic/Center | 410 L F Packer Dr, Ruleville, MS 38771-3604 | 2019-08-12 |
| Find all providers with the same taxonomy | ||||
| City | DIBERVILLE |
| Zip Code | 39540 |
Please comment or provide details below to improve the information on COASTAL FAMILY HEALTH CENTER, INC..
| 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.