| Coastline Family Medicine Pllc | |
|
2145 Country Club Rd Ste 500 Jacksonville NC 28546-2404 | |
| (910) 353-0565 | |
| (910) 353-3940 |
| Full Name | Coastline Family Medicine Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2145 Country Club Rd Ste 500, Jacksonville, North Carolina |
| Authorized Official Name and Position | Regina Yost (OWNER) |
| Authorized Official Contact | 9105481589 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastline Family Medicine Pllc 2145 Country Club Rd Ste 500 Jacksonville NC 28546-2404 Ph: (910) 353-0565 | Coastline Family Medicine Pllc 2145 Country Club Rd Ste 500 Jacksonville NC 28546-2404 Ph: (910) 353-0565 |
| NPI Number | 1952981391 |
|---|---|
| Provider Enumeration Date | 04/09/2021 |
| Last Update Date | 05/03/2023 |
| Medicare PECOS PAC ID | 2961811831 |
|---|---|
| Medicare Enrollment ID | O20210505000644 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952981391 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Regina Yost |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396375523 PECOS PAC ID: 1153759410 Enrollment ID: I20200319001941 |
| Provider Name | Heather Gallion Mewborn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750162913 PECOS PAC ID: 9537511076 Enrollment ID: I20240119001875 |
| Provider Name | Judi Curseen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730962853 PECOS PAC ID: 1951745744 Enrollment ID: I20240220003609 |
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