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COASTAL CARE INC
NPI 1538367149
Clinic/Center - Primary Care in Waycross, GA

Active since July 05, 2007
1405 ALICE ST, WAYCROSS, GA 31501(912) 285-8822(912) 490-4870 Get Directions Write a Review

NPPES record last updated: July 1, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Coastal Care Inc NPPES

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

COASTAL CARE INC (NPI 1538367149) is a healthcare organization registered as a primary care in Waycross, Georgia and active in the NPI registry since July 2007. The organization lists Warren S Theis, Owner, as its authorized official.

NPPES Registry Identity

NPI1538367149
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameCOASTAL CARE INC
Location Address1405 ALICE STWaycross, GA 31501-4528
Mailing Address1405 Alice StWaycross, GA 31501-4528 · (912) 285-8822 · Fax (912) 490-4870
Phone(912) 285-8822
Fax(912) 490-4870
Organization SubpartNo
Authorized OfficialWarren S TheisOwner · (912) 285-8822
Enumeration DateJuly 5, 2007
Last NPPES UpdateJuly 1, 2024
✔ NPI 1538367149 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
License✔ Licensed in GA · 055345
Also ListedClinic/CenterTaxonomy 261Q00000X · License 055345 (GA)
1405 ALICE ST, Waycross, GA 31501
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Other Identifiers 1

Medicaid672694005AGA

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 Care Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Coastal Care Inc, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Warren Theis, M.D.
General Practice
NPI 1588658702
1405 ALICE ST
Waycross, GA 31501
(912) 285-8822
✔ PECOS✔ Accepts MedicareSame address
Tierra Carter, NP
Nurse Practitioner
NPI 1720619554
1610 ALICE ST
Waycross, GA 31501
(912) 590-4366
✔ PECOS✔ Accepts Medicare0.2 mi

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 Care Inc's NPI number?

The NPI number for Coastal Care Inc is 1538367149. It was assigned to this organization in the NPPES registry on July 5, 2007.

Where is Coastal Care Inc located?

Coastal Care Inc is located at 1405 Alice St, Waycross, GA 31501. The listed phone number is (912) 285-8822.

What is Coastal Care Inc's specialty?

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

Is Coastal Care Inc enrolled in Medicare?

Yes. Coastal Care Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Coastal Care Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Coastal Care Inc, in General Practice and Nurse Practitioner. 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. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Coastal Care Inc was last updated on July 1, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.