COASTAL WELLNESS FAMILY MEDICINE LLC
NPI 1235632449
Clinic/Center - Primary Care in Saint Marys, GA
NPI Status: Active since March 14, 2018
Contact Information
102 LAKESHORE DR STE B
SAINT MARYS, GA
ZIP 31558
Phone: (912) 576-7546
Fax: (912) 576-2348
- Organization
- Clinic/Center
- Primary Care
- CLIA Number: 11D2178173
- CLIA Cert. Type: Practitioner Other
- CLIA Exp. Date: 01-27-2026
About COASTAL WELLNESS FAMILY MEDICINE LLC
This page provides the complete NPI Profile along with additional information for Coastal Wellness Family Medicine Llc, a primary care provider established in Saint Marys, Georgia operating as a Clinic/center, focusing in primary care . The healthcare provider is registered in the NPI registry with number 1235632449 assigned on March 2018. The practitioner's primary taxonomy code is 261QP2300X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The provider's former legal business name is Coastal Georgia Wellness Center & Family Medicine. The authorized official of this NPI record is Ms. Tavia Hall Ms, Cppm (Clinical Director)
- NPI
- 1235632449
- Provider Legal Name
- COASTAL WELLNESS FAMILY MEDICINE LLC
- Other Organization Name
- COASTAL GEORGIA WELLNESS CENTER & FAMILY MEDICINE
- Other Name Type
- Former Legal Business Name (4)
- Entity Type
- Organization
- Location Address
- 102 LAKESHORE DR STE B SAINT MARYS, GA 31558
- Location Phone
- (912) 576-7546
- Location Fax
- (912) 576-2348
- Mailing Address
- 102 LAKESHORE DR STE B SAINT MARYS, GA 31558
- Mailing Phone
- (912) 576-7546
- Mailing Fax
- (912) 576-2348
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-14-2018
- Last Update Date
- 12-03-2024
- Code Navigator
A primary care provider (PCP) like Coastal Wellness Family Medicine Llc sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Secondary Locations
- 5211 S Fletcher Ave
Fernandina Beach, FL 32034
(912) 576-7546
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Primary Care
- Taxonomy Code
- 261QP2300X
- Type
- Ambulatory Health Care Facilities
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 11D2178173
- Facility Type
- Practitioner Other
- Certificate Effective Date
- January 28, 2024
- Certificate Expiration Date
- January 27, 2026
- Laboratory Director
- SUSAN L. FRICKE-GOLDSMITH
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Coastal Wellness Family Medicine Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1235632449, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 61 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 9 providers are registered at the same or a nearby location.
SAINT MARYS, GA 31558
SAINT MARYS, GA 31558
SAINT MARYS, GA 31558
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1235632449, enumerated as an "organization" on March 14, 2018.
The provider is located at 102 LAKESHORE DR STE B SAINT MARYS, GA 31558 and the phone number is (912) 576-7546.
Clinic/Center with taxonomy code 261QP2300X and a focus in Primary Care.
