COASTAL WELLNESS FAMILY MEDICINE LLC
NPI 1235632449
Clinic/Center - Primary Care in Saint Marys, GA

Q: What is Coastal Wellness Family Medicine LLC's NPI number?

The NPI number for Coastal Wellness Family Medicine LLC is 1235632449. It was assigned to this organization in the NPPES registry on March 14, 2018. The provider was formerly known as Coastal Georgia Wellness Center & Family Medicine.

Q: What is Coastal Wellness Family Medicine LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Active since March 14, 2018

102 LAKESHORE DR STE B, SAINT MARYS, GA 31558(912) 576-7546(912) 576-2348 Get Directions Write a Review

NPPES record last updated: December 3, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 3, 2024, Jun 14, 2024, Apr 22, 2024 and 5 more (8 updates tracked since 2018).

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About Coastal Wellness Family Medicine Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COASTAL WELLNESS FAMILY MEDICINE LLC (NPI 1235632449), doing business as Coastal Georgia Wellness Center & Family Medicine, is a healthcare organization registered as a primary care in Saint Marys, Georgia and active in the NPI registry since March 2018. The organization maintains a secondary practice location in Fernandina Beach and lists Tavia Hall, Clinical Director, as its authorized official.

NPPES Registry Identity

NPI1235632449

Entity TypeOrganization

Primary Taxonomy261QP2300X

Legal Business NameCOASTAL WELLNESS FAMILY MEDICINE LLC

Location Address102 LAKESHORE DR STE BSaint Marys, GA 31558-3875

Mailing Address102 Lakeshore Dr Ste BSaint Marys, GA 31558-3875 · (912) 576-7546 · Fax (912) 576-2348

Phone(912) 576-7546

Fax(912) 576-2348

Organization SubpartNo

Authorized OfficialTavia HallClinical Director · (912) 576-7546

Enumeration DateMarch 14, 2018

Last NPPES UpdateDecember 3, 20248 updates tracked since enumeration

NPPES CertifiedDecember 3, 2024

✔ NPI 1235632449 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities

Taxonomy Code261QP2300X

Also ListedClinic/Center · Multi-SpecialtyTaxonomy 261QM1300X

102 LAKESHORE DR STE B, Saint Marys, GA 31558

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Other Names 1

Former Legal Business NameCoastal Georgia Wellness Center & Family Medicine

Secondary Practice Location 1

Location 15211 S Fletcher AveFernandina Beach, FL 32034-5370 · Phone (912) 576-7546 · Fax (912) 576-2348

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Coastal Wellness Family Medicine Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Coastal Wellness Family Medicine LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Susan Goldsmith, MSN, FNP-BC

Nurse Practitioner

NPI 1124061700

102 LAKESHORE DR STE B
Saint Marys, GA 31558

(912) 576-7546

✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Coastal Wellness Family Medicine LLC's NPI number?

The NPI number for Coastal Wellness Family Medicine LLC is 1235632449. It was assigned to this organization in the NPPES registry on March 14, 2018. The provider was formerly known as Coastal Georgia Wellness Center & Family Medicine.

Where is Coastal Wellness Family Medicine LLC located?

Coastal Wellness Family Medicine LLC is located at 102 Lakeshore Dr Ste B, Saint Marys, GA 31558. The listed phone number is (912) 576-7546.

What is Coastal Wellness Family Medicine LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Is Coastal Wellness Family Medicine LLC enrolled in Medicare?

Yes. Coastal Wellness Family Medicine LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Coastal Wellness Family Medicine LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Coastal Wellness Family Medicine LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Coastal Wellness Family Medicine LLC accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Coastal Wellness Family Medicine LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Coastal Wellness Family Medicine LLC was last updated on December 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.