Coastal Caremd

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

COASTAL CAREMD

Practice address

974 Ribaut Rd
Beaufort, SC 29902-5486

Phone

(843) 524-3344

Fax

(843) 524-5574

NPI assigned

Jan 20, 2009

Last updated

Jan 20, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Clark Trask, MD

Title

Owner

Phone

(843) 525-3344

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Samuel Clark Trask, MD

  • Family Medicine Physician
  • Beaufort, SC
  • NPI 1730160896
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1232409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232409600000",
    "number": "1023255650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "974 RIBAUT RD",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299025486",
            "telephone_number": "843-524-3344",
            "fax_number": "843-524-5574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "974 RIBAUT RD",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299025486",
            "telephone_number": "843-524-3344",
            "fax_number": "843-524-5574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CAREMD",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-20",
        "last_updated": "2009-01-20",
        "status": "A",
        "authorized_official_last_name": "TRASK",
        "authorized_official_first_name": "CLARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-525-3344",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• City of Beaufort
• Samuel Jason Clark, PHYSICIAN ASSISTANT
• Barbara A. Clarke, LICENSED PSYCHOLOGIS
• Marsha Elizabeth Clyburn, RDH
• Coastal Cardiovascular Clinic
• Coastal Carolina Surgical Assoc
• Coastal Carolina Urology Group LLC
• Coastal Carolina Urology Group, LLC
• Coastal Empire
• Coastal Empire Community Mental Health Center

• Family Medicine Physician in Beaufort, SC
• Providers in Beaufort, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.