Coastal Rehabilitation & Wellness – Physical Therapist, NPI 1043375520

Coastal Rehabilitation & Wellness is a healthcare provider. based in Brookings, Oregon. specializing in Physical Therapist. The organization holds a License No. 3984 (OR). The NPI Number for Coastal Rehabilitation & Wellness is 1043375520

Main info

Organization
Name
Coastal Rehabilitation & Wellness
NPI
1043375520
Phone
(541) 469-7314
Address
580 5TH ST
Authorized Official
JAMIE DAUGHERTY CEO RN
Enumeration Date
26 December 2006
Last Update Date
14 August 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness90
Years active:19State licenses:1Digital endpoints

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Provider Addresses for Coastal Rehabilitation & Wellness

  • 580, 5th Street, Brookings, Brookings Township, Brookings County, South Dakota, 57006, United States

    SUITE 600

    BROOKINGS, OR 974158329

    Phone: (541) 469-7314

    Fax: (541) 469-3669

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-10-17

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20251017004052OClinic/Group PracticeORTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 97415)

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Reviews

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Frequently asked questions

Is there an official ID for Coastal Rehabilitation & Wellness in U.S. healthcare records?
The official identifier for Coastal Rehabilitation & Wellness is NPI 1043375520.
Would Coastal Rehabilitation & Wellness appear as active to a payer?
You can treat Coastal Rehabilitation & Wellness as active for directory purposes; confirm clinical privileges separately.
What expertise is attributed to Coastal Rehabilitation & Wellness?
Coastal Rehabilitation & Wellness's specialty line reads Physical Therapist. Clinical services aligned with this taxonomy classification.
Where in Oregon is Coastal Rehabilitation & Wellness registered?
Use Brookings, Oregon as the headline location for Coastal Rehabilitation & Wellness here.
When was this NPI issued?
Enumeration for Coastal Rehabilitation & Wellness is noted as December 26, 2006 where the registry provides it.

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