Coastal Pediatric Associates, P.a.

Primary specialty

Health Service PsychologistTaxonomy code 103TH0100X

Legal business name

COASTAL PEDIATRIC ASSOCIATES, P.A.

Practice address

2051 Charlie Hall Blvd
Charleston, SC 29414-5834

Phone

(843) 737-9467

Fax

(843) 371-5507

NPI assigned

Mar 30, 2018

Last updated

Mar 30, 2018By 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

Dana Wolf

Title

Director of Quality Programs

Phone

(843) 284-4258

Specialties & licenses 1

Addresses

Tax ID family

Coastal Pediatric Associates3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Coastal Pediatric Associates, P.a.

  • Pediatrics Physician
  • Charleston, SC
  • NPI 1770700759
  NPD tax ID
• Coastal Pediatric Associates, PA

  • Pediatrics Physician
  • Mount Pleasant, SC
  • NPI 1851680896
  NPD tax ID

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

{
    "created_epoch": "1522368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522368000000",
    "number": "1083110019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2051 CHARLIE HALL BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145834",
            "telephone_number": "843-737-9467",
            "fax_number": "843-371-5507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2051 CHARLIE HALL BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145834",
            "telephone_number": "843-737-9467",
            "fax_number": "843-371-5507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL PEDIATRIC ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-30",
        "last_updated": "2018-03-30",
        "status": "A",
        "authorized_official_last_name": "WOLF",
        "authorized_official_first_name": "DANA",
        "authorized_official_title_or_position": "DIRECTOR OF QUALITY PROGRAMS",
        "authorized_official_telephone_number": "843-284-4258"
    },
    "taxonomies": [
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coastal Inpatient Physicians, LLC
• Coastal Kids Dental
• Coastal Kids Dental & Braces
• Coastal Management Group
• Coastal Neurosurgery and Spine
• Coastal Pediatric Associates, P.a.
• Coastal Play 2 Grow Therapy, LLC
• Coastal Psychiatry, LLC
• Coastal Pulmonary, LLP
• Coastal Vascular & Vein Center, LLC

• Health Service Psychologist in Charleston, SC
• Providers in Charleston, SC by specialty
• Health Service Psychologist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2018; 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.