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COASTAL MANOR NURSING HOME
NPI 1265463004
Skilled Nursing Facility in Ludowici, GA

Active since July 06, 2006CLIA 11D0964464 · Waiver
HWY 84 EAST, LUDOWICI, GA 31316(912) 545-3392(912) 545-9588 Get Directions Write a Review

NPPES record last updated: January 6, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Coastal Manor Nursing Home NPPES

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

COASTAL MANOR NURSING HOME (NPI 1265463004) is a healthcare organization registered as a skilled nursing facility in Ludowici, Georgia and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through August 25, 2027 and lists Derek Rozier, Cfo, as its authorized official.

NPPES Registry Identity

NPI1265463004
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameHOSPITAL AUTHORITY OF LIBERTY COUNTY
Location AddressHWY 84 EASTLudowici, GA 31316
Mailing AddressRr 3 Box 2dLudowici, GA 31316-9701 · (912) 545-3392 · Fax (912) 545-9588
Phone(912) 545-3392
Fax(912) 545-9588
Organization SubpartYes
Authorized OfficialDerek RozierCfo · (912) 369-9427
Enumeration DateJuly 6, 2006
Last NPPES UpdateJanuary 6, 2022
NPPES CertifiedJanuary 6, 2022
✔ NPI 1265463004 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
HWY 84 EAST, Ludowici, GA 31316
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Other Names 1

Doing Business AsCoastal Manor Nursing Home

Other Identifiers 1

Medicaid000856028AGA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Coastal Manor Nursing Home is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by February 28, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateGeorgiaEnrollment IDO20040428000377Non-DME Part B · Clinic/Group PracticeDue dateFebruary 28, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

24

Medicare enrollment records show 24 clinicians reassign Medicare billing to Coastal Manor Nursing Home, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 7

Nurse Practitioner11
Obstetrics/Gynecology6
General Surgery2
Internal Medicine2
Emergency Medicine1
Orthopedic Surgery1
Pediatric Medicine1

Nearest to this location (20)

See all 24
Thomas Crutchfield, FNP-C
Nurse Practitioner
NPI 1306565460
153 CYPRESS CREEK DR NE
Ludowici, GA 31316
(912) 271-8678
✔ PECOS5.0 mi
Tiffany Torres-Graham, FNP
Nurse Practitioner
NPI 1417841982
462 ELMA G MILES PKWY
Hinesville, GA 31313
(912) 369-9412
✔ PECOS8.9 mi
Nicole Broerman, MD
Pediatric Medicine
NPI 1013902741
462 ELMA G MILES PKWY
Hinesville, GA 31313
(912) 369-9400
✔ PECOS10 mi
Jasmine Leonard
Nurse Practitioner
NPI 1891611786
462 ELMA G MILES PKWY
Hinesville, GA 31313
(912) 369-9400
✔ PECOS10 mi
Mary Close, NP
Nurse Practitioner
NPI 1942468475
462 ELMA G MILES PKWY STE 102A
Hinesville, GA 31313
(912) 369-9400
✔ PECOS✔ Accepts Medicare10 mi
Calin Badea, M.D.
Internal Medicine
NPI 1346239639
455 S MAIN ST STE 104
Hinesville, GA 31313
(912) 876-5644
✔ PECOS✔ Accepts Medicare11 mi
Rebecca Coefield, M.D.
General Surgery
NPI 1609929512
455 S MAIN ST STE 105
Hinesville, GA 31313
(912) 876-5505
✔ PECOS✔ Accepts Medicare11 mi
Danielle Elam, NP
Nurse Practitioner
NPI 1962001255
455 S MAIN ST STE 104
Hinesville, GA 31313
(912) 369-9400
✔ PECOS✔ Accepts Medicare11 mi
Seth Borquaye, M.D.
Obstetrics/Gynecology
NPI 1346338878
455 S MAIN ST SUITE 202
Hinesville, GA 31313
(912) 877-2228
✔ PECOS✔ Accepts Medicare11 mi
Wendy Lewis, NP
Nurse Practitioner
NPI 1164454328
455 S MAIN ST STE 105
Hinesville, GA 31313
(912) 876-5505
✔ PECOS✔ Accepts Medicare11 mi
Nicole Dutton-Andrews, FNP-BC
Nurse Practitioner
NPI 1346006715
455 S MAIN ST
Hinesville, GA 31313
(912) 369-9400
✔ PECOS12 mi
Christina Mccain, M.D.
General Surgery
NPI 1053464958
1061 HARMON AVE
Fort Stewart, GA 31314
(912) 435-6965
✔ PECOS✔ Accepts Medicare12 mi
Ogochukwu Okpala, MD, MPH, MBA
Obstetrics/Gynecology
NPI 1407925324
228 MEMORIAL DR
Jesup, GA 31545
(912) 559-2432
✔ PECOS✔ Accepts Medicare14 mi
Jeffrey Harris, MD
Obstetrics/Gynecology
NPI 1801850094
371 PEACHTREE ST
Jesup, GA 31545
(912) 530-7301
✔ PECOS✔ Accepts Medicare15 mi
Carleigh Griner, FNP-C
Nurse Practitioner
NPI 1518851443
586 ISLANDS HWY
Midway, GA 31320
(912) 396-7050
✔ PECOS✔ Accepts Medicare24 mi
Traiana Pacurar, M.D.
Internal Medicine
NPI 1811986003
586 ISLANDS HIGHWAY
Midway, GA 31320
(912) 396-7050
✔ PECOS✔ Accepts Medicare24 mi
Baylee Lamberth, FNP
Nurse Practitioner
NPI 1679337976
155 WILDLIFE VW CT N
Richmond Hill, GA 31324
(478) 447-2596
✔ PECOS✔ Accepts Medicare34 mi
Rebecca Skeen, FNP
Nurse Practitioner
NPI 1356122303
106 SHOPPERS WAY
Brunswick, GA 31525
(912) 275-8028
✔ PECOS✔ Accepts Medicare42 mi
Greer Noonburg, MD
Orthopedic Surgery
NPI 1417999889
4425 PAULSEN ST
Savannah, GA 31405
(912) 355-6615
✔ PECOS✔ Accepts Medicare44 mi
Bradley Post
Emergency Medicine
NPI 1013969708
4700 WATERS AVE
Savannah, GA 31404
(912) 350-3849
✔ PECOS44 mi
See all 24 clinicians

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D0964464

Coastal Manor · Ludowici, GA
Active · expires Aug 25, 2027
CLIA Number11D0964464
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateAugust 26, 2025
Certificate Expiration DateAugust 25, 2027
Laboratory DirectorDonald L. Lovette
Laboratory Phone(912) 369-9400
Laboratory LocationCoastal Manor82 Ludowici Industrial Park, Ludowici, GA 31316
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

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 Hospital Authority Of Liberty County's NPI number?

The NPI number for Hospital Authority Of Liberty County is 1265463004. It was assigned to this organization in the NPPES registry on July 6, 2006. The provider is doing business as Coastal Manor Nursing Home.

Where is Hospital Authority Of Liberty County located?

Hospital Authority Of Liberty County is located at Hwy 84 East, Ludowici, GA 31316. The listed phone number is (912) 545-3392.

What is Hospital Authority Of Liberty County's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Is Hospital Authority Of Liberty County enrolled in Medicare?

Yes. Hospital Authority Of Liberty County is registered in the Medicare PECOS enrollment system.

When is Hospital Authority Of Liberty County's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Georgia, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Hospital Authority Of Liberty County?

According to the CMS Revalidation Reassignment List (October 2026 release), 24 clinicians in 7 Medicare specialties reassign their Medicare billing to Hospital Authority Of Liberty County. 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. The largest specialties are Nurse Practitioner (11), Obstetrics/Gynecology (6) and General Surgery (2). Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Hospital Authority Of Liberty County hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D0964464) is associated with this NPI, valid through August 25, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Hospital Authority Of Liberty County accept?

Health plans from Oscar Health list Hospital Authority Of Liberty County 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 Hospital Authority Of Liberty County was last updated on January 6, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.