| Coastal Southeastern United Care | |
|
10 Doctors Circle Suite 6 Supply NC 28462 | |
| (910) 755-5222 | |
| (910) 755-5255 |
| Full Name | Coastal Southeastern United Care |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 10 Doctors Circle, Supply, North Carolina |
| Authorized Official Name and Position | Shannon Ashley Atkinson (VP, HOME AND COMMUNITY SERVICES) |
| Authorized Official Contact | 8438062695 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Southeastern United Care 305 Commerce Ave Suite 102 Morehead City NC 28557 Ph: (252) 773-0195 | Coastal Southeastern United Care 10 Doctors Circle Suite 6 Supply NC 28462 Ph: (910) 755-5222 |
| NPI Number | 1346477403 |
|---|---|
| Provider Enumeration Date | 06/16/2009 |
| Last Update Date | 09/27/2023 |
| Certification Date | 09/27/2023 |
| Medicare PECOS PAC ID | 6204089188 |
|---|---|
| Medicare Enrollment ID | O20121228000121 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346477403 | NPI | - | NPPES |
| 8302940 | Medicaid | NC | |
| 8302940B | Medicaid | NC | |
| 8302940H | Medicaid | NC | |
| B913 | Other | NC | MEDICARE |
| 8302940G | Medicaid | NC |
| Provider Name | Robert Seigel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912043050 PECOS PAC ID: 9931295664 Enrollment ID: I20071011000093 |
| Provider Name | David Alan Joseph |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619027471 PECOS PAC ID: 3971655051 Enrollment ID: I20090721000490 |
| Provider Name | Kathy Asbury |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356598619 PECOS PAC ID: 1456411073 Enrollment ID: I20110105001120 |
| Provider Name | Brenda Sue Willis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831372721 PECOS PAC ID: 8628238326 Enrollment ID: I20120404000011 |
| Provider Name | Brittany Carol Barnes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891079539 PECOS PAC ID: 5496980799 Enrollment ID: I20131022001281 |
| Provider Name | Brittany Hales |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235569500 PECOS PAC ID: 5597061200 Enrollment ID: I20160307001432 |
| Provider Name | Heidi Michell Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629456330 PECOS PAC ID: 4183920465 Enrollment ID: I20160314000028 |
| Provider Name | Whitnee L Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578934576 PECOS PAC ID: 7719261809 Enrollment ID: I20170508001220 |
| Provider Name | Sheila Cannon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003859158 PECOS PAC ID: 3375619620 Enrollment ID: I20170728000005 |
| Provider Name | Meredith Morrow Hartsell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700372620 PECOS PAC ID: 0749538544 Enrollment ID: I20180810001888 |
| Provider Name | Elizabeth Barton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003374208 PECOS PAC ID: 2860723681 Enrollment ID: I20191009001763 |
| Provider Name | Crystal Martinez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972068757 PECOS PAC ID: 9234560657 Enrollment ID: I20200518003144 |
| Provider Name | Mallory R Parker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588183602 PECOS PAC ID: 0941628390 Enrollment ID: I20200916002011 |
| Provider Name | Allison D Kinlaw |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528618352 PECOS PAC ID: 4486067766 Enrollment ID: I20210105002173 |
| Provider Name | Gloria L Bailey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497251888 PECOS PAC ID: 9931505906 Enrollment ID: I20210831002422 |
| Provider Name | Virginia Faye Bradley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427625128 PECOS PAC ID: 1254737018 Enrollment ID: I20210902002762 |
| Provider Name | Molly Madison Mcgirt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215688700 PECOS PAC ID: 7012302185 Enrollment ID: I20220328002179 |
| Provider Name | Sydney Elizabeth Dockery |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811558596 PECOS PAC ID: 1557758463 Enrollment ID: I20220425000149 |
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