Coastal Wellness Family Medicine LLC
NPI 1235632449 · Primary Care Clinic/Center · Saint Marys, GA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Coastal Wellness Family Medicine LLC is a Primary Care Clinic/Center organization in Saint Marys, GA (NPI 1235632449).
Provider details
- NPI number
- 1235632449
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Tavia Hall, Clinical Director(912) 576-7546
Specialties & taxonomies
Ambulatory Health Care Facilities
- Multi-Specialty Clinic/Center261QM1300X
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Former legal business name
- Coastal Georgia Wellness Center & Family Medicine
- Former legal business name
- Coastal Georgia Wellness Center & Family Medicine
Additional practice locations (1)
- 5211 S Fletcher AveFernandina Beach, FL 32034-5370Phone: (912) 576-7546Fax: (912) 576-2348
Registry dates
- Enumerated
- 2018-03-14
- Last updated
- 2024-12-03
- Certified
- 2024-12-03
Frequently asked questions
- What is Coastal Wellness Family Medicine LLC's NPI number?
- Coastal Wellness Family Medicine LLC's National Provider Identifier (NPI) is 1235632449, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Coastal Wellness Family Medicine LLC?
- Coastal Wellness Family Medicine LLC is classified in the NPPES registry as Primary Care Clinic/Center (Ambulatory Health Care Facilities).
- Where is Coastal Wellness Family Medicine LLC located?
- Coastal Wellness Family Medicine LLC's practice location on file with NPPES is 102 Lakeshore Dr Ste B, Saint Marys, GA 31558-3875.
- What is Coastal Wellness Family Medicine LLC's phone number?
- The practice phone number listed in the NPPES registry for Coastal Wellness Family Medicine LLC is (912) 576-7546.
- Does Coastal Wellness Family Medicine LLC accept Medicare?
- Coastal Wellness Family Medicine LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Coastal Wellness Family Medicine LLC?
- The authorized official listed on Coastal Wellness Family Medicine LLC's NPPES record is Tavia Hall, Clinical Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Coastal Wellness Family Medicine LLC's NPI active?
- Yes — Coastal Wellness Family Medicine LLC's NPI (1235632449) is active in the NPPES registry as of the last update on 2024-12-03.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.