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COASTAL SOUTHEASTERN FAMILY PRACTICE, PLLC
NPI 1699067488
Nurse Practitioner - Family in Pembroke, NC

Active since May 11, 2011CLIA 34D2031984 · Waiver
205 W 3RD ST, PEMBROKE, NC 28372(910) 521-0099(910) 521-0088 Get Directions Write a Review

NPPES record last updated: March 7, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Coastal Southeastern Family Practice, Pllc NPPES

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

COASTAL SOUTHEASTERN FAMILY PRACTICE, PLLC (NPI 1699067488) is a healthcare organization registered as a family in Pembroke, North Carolina and active in the NPI registry since May 2011. The organization holds a CLIA Waiver certificate valid through November 1, 2027 and lists Katara S Chavis, President, as its authorized official.

NPPES Registry Identity

NPI1699067488
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameCOASTAL SOUTHEASTERN FAMILY PRACTICE, PLLC
Location Address205 W 3RD STPembroke, NC 28372-8768
Mailing Address205 W 3rd StPembroke, NC 28372-8768 · (910) 521-0099 · Fax (910) 521-0088
Phone(910) 521-0099
Fax(910) 521-0088
Organization SubpartNo
Authorized OfficialKatara S ChavisPresident · (910) 521-0099
Enumeration DateMay 11, 2011
Last NPPES UpdateMarch 7, 2017
✔ NPI 1699067488 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in NC · 5005148
205 W 3RD ST, Pembroke, NC 28372
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee.Insurance ›

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 34D2031984

Coastal Southeastern Family Practice, PLLC · Pembroke, NC
Active · expires Nov 1, 2027
CLIA Number34D2031984
Laboratory TypePhysician Office
Certificate Effective DateNovember 2, 2025
Certificate Expiration DateNovember 1, 2027
Laboratory DirectorKatara S. Chavis
Laboratory Phone(910) 521-0099
Laboratory LocationCoastal Southeastern Family Practice, PLLC205 W Third Street, Pembroke, NC 28372
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

MRS. KATARA S CHAVIS FNP-C
Nurse Practitioner (Family)
205 W 3RD ST
PEMBROKE, NC 28372
Robeson County (910) 521-0099
PEMBROKE DRUG HOLDINGS, LLC
Pharmacy (Community/Retail Pharmacy)
205 W 3RD ST
PEMBROKE, NC 28372
Robeson County (910) 775-9209
PEMBROKE DRUG HOLDINGS, LLC
Pharmacy (Long Term Care Pharmacy)
205 W 3RD ST
PEMBROKE, NC 28372
Robeson County (910) 775-9209

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 Southeastern Family Practice, PLLC's NPI number?

The NPI number for Coastal Southeastern Family Practice, PLLC is 1699067488. It was assigned to this organization in the NPPES registry on May 11, 2011.

Where is Coastal Southeastern Family Practice, PLLC located?

Coastal Southeastern Family Practice, PLLC is located at 205 W 3rd St, Pembroke, NC 28372. The listed phone number is (910) 521-0099.

What is Coastal Southeastern Family Practice, PLLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Does Coastal Southeastern Family Practice, PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D2031984) is associated with this NPI, valid through November 1, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Coastal Southeastern Family Practice, PLLC accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina and Ambetter of Tennessee list Coastal Southeastern Family Practice, PLLC 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 Coastal Southeastern Family Practice, PLLC was last updated on March 7, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.