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COASTAL COMMUNITY CENTER INC
NPI 1295690527
Nurse Practitioner - Primary Care in Provo, UT

Active since December 18, 2025
3650 N UNIVERSITY AVE STE 150, PROVO, UT 84604(702) 809-2505 Get Directions Write a Review

NPPES record last updated: December 18, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Coastal Community Center Inc NPPES

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

COASTAL COMMUNITY CENTER INC (NPI 1295690527) is a healthcare organization registered as a primary care in Provo, Utah and active in the NPI registry since December 2025. The organization lists Ayushmaan Srinivasa, Board Member, as its authorized official.

NPPES Registry Identity

NPI1295690527
Entity TypeOrganization
Primary Taxonomy363LP2300X
Legal Business NameCOASTAL COMMUNITY CENTER INC
Location Address3650 N UNIVERSITY AVE STE 150Provo, UT 84604-6636
Mailing Address3650 N University Ave Ste 150Provo, UT 84604-6636
Phone(702) 809-2505
Organization SubpartNo
Authorized OfficialAyushmaan SrinivasaBoard Member · (702) 809-2505
Enumeration DateDecember 18, 2025
NPPES CertifiedDecember 18, 2025
✔ NPI 1295690527 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
Also ListedInternal MedicineTaxonomy 207R00000X
3650 N UNIVERSITY AVE STE 150, Provo, UT 84604
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

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

MR. DARCY T TROTTER APRN-BC
Nurse Practitioner (Adult Health)
3650 N UNIVERSITY AVE STE 150
PROVO, UT 84604
Utah County (801) 818-1940
DR. WENSHU YU MD
Internal Medicine (Rheumatology)
3650 N UNIVERSITY AVE STE 150
PROVO, UT 84604
Utah County (801) 818-1940

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 Community Center Inc's NPI number?

The NPI number for Coastal Community Center Inc is 1295690527. It was assigned to this organization in the NPPES registry on December 18, 2025.

Where is Coastal Community Center Inc located?

Coastal Community Center Inc is located at 3650 N University Ave Ste 150, Provo, UT 84604. The listed phone number is (702) 809-2505.

What is Coastal Community Center Inc's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

When was this NPI record last updated?

The NPPES record for Coastal Community Center Inc was last updated on December 18, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.