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

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: July 26, 2026.

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

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
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

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

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Family)
102 LAKESHORE DR STE B
SAINT MARYS, GA 31558
Counselor (Mental Health)
102 LAKESHORE DR STE B
SAINT MARYS, GA 31558
Clinic/Center (Primary Care)
102 LAKESHORE DR STE B
SAINT MARYS, GA 31558
Clinic/Center (Primary Care)
102 LAKESHORE DR STE B
SAINT MARYS, GA 31558
Social Worker (Clinical)
102 LAKESHORE DR STE B
SAINT MARYS, GA 31558
Nurse Practitioner
102 LAKESHORE DR STE B
SAINT MARYS, GA 31558
Community/Behavioral Health
102 LAKESHORE DR STE B
SAINT MARYS, GA 31558
Community/Behavioral Health
102 LAKESHORE DR STE B
SAINT MARYS, GA 31558

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.

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 with the weekly NPPES data releases published by CMS.