Coastal Physical Medicine, PA

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

19612 Issued in SC

Legal business name

COASTAL PHYSICAL MEDICINE, PA

Practice address

3185 Azalea Dr
North Charleston, SC 29405-8211

Phone

(843) 762-2274

Fax

(843) 762-2278

NPI assigned

Feb 27, 2008

Last updated

Feb 27, 2008By 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

Rebecca McSwain

Title

Practice Manager

Phone

(843) 762-2274

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

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.

• Kerri A Kolehma, MD

  • Specialist
  • N Charleston, SC
  • NPI 1760587034
  Medicare reassignment NPD

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

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204070400000",
    "number": "1053580662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12819",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294222819",
            "telephone_number": "843-762-2274",
            "fax_number": "843-762-2278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3185 AZALEA DR",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294058211",
            "telephone_number": "843-762-2274",
            "fax_number": "843-762-2278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL PHYSICAL MEDICINE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-27",
        "last_updated": "2008-02-27",
        "status": "A",
        "authorized_official_last_name": "MCSWAIN",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "843-762-2274"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "SC",
            "license": "19612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2989",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Coastal Kids Dental & Braces
• Coastal Kids Dental PA
• Coastal Neurosurgical Specialists, LLC
• Coastal Oral and Maxillofacial Surgery, PC
• Coastal Pain Care, LLC
• Coastal Spine and Sport, LLC
• Iesha Coaxum
• Erin E. Cobb, LISW-CP
• Serena Cobb, APRN-FNP
• Yvette Cobbs

• Medical Specialty Clinic/Center in North Charleston, SC
• Providers in North Charleston, SC by specialty
• Medical Specialty Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.