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INTRACOASTAL INTERNAL MEDICINE
NPI 1770515272
Internal Medicine in Wilmington, NC

Active since July 07, 2006CLIA 34D1051890 · Waiver
2580 PICKARD RD, WILMINGTON, NC 28403(910) 332-0701(910) 332-0710 Get Directions Write a Review

NPPES record last updated: June 19, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 19, 2019, Apr 24, 2019, Apr 8, 2019 (3 updates tracked since 2019).

About Intracoastal Internal Medicine NPPES

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

INTRACOASTAL INTERNAL MEDICINE (NPI 1770515272) is a healthcare organization registered as an internal medicine in Wilmington, North Carolina and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through March 13, 2028 and lists Kimberly Dahlstrom, Admin Asst, as its authorized official.

NPPES Registry Identity

NPI1770515272
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameINTRACOASTAL INTERNAL MEDICINE
Location Address2580 PICKARD RDWilmington, NC 28403-4461
Mailing Address2580 Pickard RdWilmington, NC 28403-4461 · (910) 332-0701 · Fax (910) 332-0710
Phone(910) 332-0701
Fax(910) 332-0710
Organization SubpartNo
Authorized OfficialKimberly DahlstromAdmin Asst · (910) 332-0701
Enumeration DateJuly 7, 2006
Last NPPES UpdateJune 19, 20193 updates tracked since enumeration
✔ NPI 1770515272 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
2580 PICKARD RD, Wilmington, NC 28403
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Other Identifiers 7

Medicaid1447204631NC
Medicaid891069VNC
Medicaid5903216NC
Medicaid1467917880NC
Medicaid7005481NC
Medicaid8911484NC
Medicaid7005555NC

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

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 34D1051890

Intracoastal Internal Medicine PA · Wilmington, NC
Active · expires Mar 13, 2028
CLIA Number34D1051890
Laboratory TypePhysician Office
Certificate Effective DateMarch 14, 2026
Certificate Expiration DateMarch 13, 2028
Laboratory DirectorChris C. Cosgrove
Laboratory Phone(910) 395-1543
Laboratory LocationIntracoastal Internal Medicine PA2580 Pickard Road, Wilmington, NC 28403
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

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

MRS. MICHELLE WILLIAMS RICHARDSON FNP
Nurse Practitioner (Family)
2580 PICKARD RD
WILMINGTON, NC 28403
New Hanover County (910) 332-0701
JENNY LEE TREST PERKINS FNP-BC
Nurse Practitioner (Primary Care)
2580 PICKARD RD
WILMINGTON, NC 28403
New Hanover County (910) 332-0701
MRS. ERIN CAUDLE DILLS FNP
Nurse Practitioner (Family)
2580 PICKARD RD
WILMINGTON, NC 28403
New Hanover County (910) 332-0701
MRS. ASHLEY ROSE HORNE FNP-C
Nurse Practitioner (Family)
2580 PICKARD RD
WILMINGTON, NC 28403
New Hanover County (910) 332-0701
MS. LORRAINE KELLY NP
Nurse Practitioner (Primary Care)
2580 PICKARD RD
WILMINGTON, NC 28403
New Hanover County (910) 332-0701

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 Intracoastal Internal Medicine's NPI number?

The NPI number for Intracoastal Internal Medicine is 1770515272. It was assigned to this organization in the NPPES registry on July 7, 2006.

Where is Intracoastal Internal Medicine located?

Intracoastal Internal Medicine is located at 2580 Pickard Rd, Wilmington, NC 28403. The listed phone number is (910) 332-0701.

What is Intracoastal Internal Medicine's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Intracoastal Internal Medicine hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D1051890) is associated with this NPI, valid through March 13, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Intracoastal Internal Medicine was last updated on June 19, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.