NPIMap

Organization Active NPI

Coastal Carolina University Student Health Services

  • Student Health Clinic/Center
  • Conway, SC
National Provider Identifier
1083800858
Registry record updated Sep 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
License
27353 Issued in SC
Legal business name
COASTAL CAROLINA UNIVERSITY STUDENT HEALTH SERVICES
Practice address
204 University Blvd
Conway, SC 29526-8834
Phone
(843) 349-6543
NPI assigned
Sep 14, 2007
Last updated
Sep 14, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2007

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

Authorized official

Name
Mr. Caesar Ross
Title
Director
Phone
(843) 349-6543

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X 27353 SC Primary

Addresses

Primary practice location

204 University Blvd
Conway, SC 29526-8834

Mailing address

PO Box 261954
Conway, SC 29528-6054
Phone (843) 349-6543

National Provider Directory

National Provider Directory
Tax ID family
Coastal Carolina University Counseling Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1189728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189728000000",
    "number": "1083800858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 261954",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295286054",
            "telephone_number": "843-349-6543",
            "fax_number": "843-349-6546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 UNIVERSITY BLVD",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295268834",
            "telephone_number": "843-349-6543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CAROLINA UNIVERSITY STUDENT HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-14",
        "last_updated": "2007-09-14",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "CAESAR",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "843-349-6543",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": "SC",
            "license": "27353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2007; 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.