COASTAL MEDSURG, INC. (NPI# 1861969164) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861969164 |
| Entity Type | Organization |
| Organization Name | COASTAL MEDSURG, INC. |
| Practice Address |
1700 Will O Wisp Dr Virginia Beach VA 23454-3164 |
| Mailing Address |
604 Bishop Dr Virginia Beach VA 23455-6544 |
| Practice Telephone | 7574966400 |
| Enumeration Date | 2018-10-25 |
| Last Update Date | 2018-10-25 |
| Authorized Official Name | EDWARD WILSON (PRESIDENT) |
| Authorized Official Telephone | 7576723738 |
| Authorized Official Credential | CSA, RSA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1700 WILL O WISP DR |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23454-3164 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528027026 | Virginia Beach Ambulatory Surgery Center | Clinic/Center | 1700 Will O Wisp Dr, Virginia Beach, VA 23454-3164 | 2006-03-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356994263 | Agape Consulting | Behavioral Analyst | 1216 Garth Court, Virginia Beach, VA 23454 | 2019-07-19 |
| 1831650266 | Amelia Jo Crutsinger | Physician Assistant | 1644 Kepler Bnd, Virginia Beach, VA 23454 | 2019-03-28 |
| 1538639158 | Bay Psychiatric II Inc | Counselor | 923 First Colonial Rd Suite 1821, Virginia Beach, VA 23454 | 2018-11-26 |
| 1487151759 | Akanksha Mohan | Student in an Organized Health Care Education/Training Program | 100 Mannng Drive, Chapel Hill, Nc 27514, Chapel Hill, NC 23454 | 2018-04-12 |
| 1275038580 | Food Lion, LLC | Durable Medical Equipment & Medical Supplies | 1615 General Booth Blvd, Virginia Beach, VA 23454 | 2018-03-28 |
| 1346783164 | Tracy Chasse | Occupational Therapy Assistant | 1628 Old Donation Parkway, Virginia Beach, VA 23454 | 2016-11-28 |
| 1982066627 | Jennifer Mitchell | Speech-Language Pathologist | 2101 Agecroft Rd., Virginia Beach, VA 23454 | 2016-03-22 |
| 1659730562 | Rebecca Houvener | Psychologist | 1120 First Colonial Rd Ste 202, Virginia Beach, VA 23454 | 2016-02-19 |
| 1932581741 | Monica Jane Bailey | Nurse Practitioner | 2110 N Great Neck Rd, Virginia Beach, VA 23454 | 2015-06-29 |
| 1376930073 | Ashley A Burkholder | Family Medicine | 1024 First Colonial Rd Ste 104, Virginia Beach, VA 23454 | 2015-04-20 |
| Find all providers in zip 23454 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588915425 | Edward S Wilson | Physician Assistant | 604 Bishop Dr, Virginia Beach, VA 23455 | 2012-10-01 |
| 1811126923 | Derik Thompson | Physician Assistant | 2085 Lynnhaven Pkwy Ste 106-308, Virginia Beach, VA 23456-1497 | 2009-07-09 |
| 1912195314 | David John Pullen | Physician Assistant | 5557 Princess Anne Rd, Virginia Beach, VA 23462-3344 | 2007-10-10 |
| 1275696569 | Physician Assistant Services Inc | Physician Assistant | 2132 Creeks Edge Dr, Virginia Beach, VA 23451-6804 | 2006-12-18 |
| 1356456677 | Deborah D Redmond | Physician Assistant | 2233 Elder Rd, Virginia Beach, VA 23451 | 2006-08-19 |
| 1790166692 | Melody Lynne Osborne | Physician Assistant | 2075 Glenn Mitchell Dr, Suite 512, Virginia Beach, VA 23456-0179 | 2015-06-16 |
| 1750612701 | Nicolle Lin Stopa | Physician Assistant | 1060 First Colonial Rd, Virginia Beach, VA 23454-3002 | 2010-01-14 |
| 1558319061 | John Philip Conza | Physician Assistant | 1550 Tomcat Blvd, Branch Health Clinic Oceana, Virginia Beach, VA 23464 | 2006-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962038042 | Emma Alexandra Rouse | Physician Assistant | 2712 Hatmark St, Vienna, VA 22181-6054 | 2020-03-20 |
| 1861059461 | Daniel P Sherman | Physician Assistant | 43165 Thistledown Ter Apt 241, Broadlands, VA 20148-4075 | 2019-05-20 |
| 1184289753 | Vicenta Hanh-phuoc Tran | Physician Assistant | 7611 Trammell Rd, Annandale, VA 22003-1442 | 2019-05-08 |
| 1649833021 | Karlie Diruzza | Physician Assistant | 2900 Lamb Cir # L760, Christiansburg, VA 24073-6344 | 2019-04-21 |
| 1164983599 | Bradley Pretzer | Physician Assistant | 5115 Cliffhaven Dr, Annandale, VA 22003-4348 | 2019-03-28 |
| 1346757416 | Hinda Yasmin Mezaache | Physician Assistant | 1101 Sam Perry Blvd Ste 219, Fredericksburg, VA 22401-4465 | 2018-01-10 |
| 1265974851 | Gerard Surgical Services, LLC | Physician Assistant | 12220 Chattanooga Plz Ste 121, Midlothian, VA 23112-4865 | 2016-11-14 |
| 1417301607 | Jose Gustavo Espino | Physician Assistant | 6866 Deer Run Dr, Alexandria, VA 22306-1124 | 2016-04-14 |
| 1477915098 | Kelly Egan Weaver | Physician Assistant | 1201 Broad Rock Blvd Richmond Va 23224, Richmond, VA 23249-4915 | 2016-03-23 |
| 1871976522 | Hall Surgical Assistance, LLC | Physician Assistant | 10332 Main St, Suite #344, Fairfax, VA 22030-2410 | 2015-06-30 |
| Find all providers with the same taxonomy | ||||
| City | VIRGINIA BEACH |
| Zip Code | 23454 |
Please comment or provide details below to improve the information on COASTAL MEDSURG, 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.