Kennasia Coaxum

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

57100 Issued in SC

Practice address

469 Gianna LN
Goose Creek, SC 29445-3672

Phone

(843) 781-0112

NPI assigned

Jun 22, 2026

Last updated

Jun 22, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1782086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1093641763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "469 GIANNA LN",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294453672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "469 GIANNA LN",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294453672",
            "telephone_number": "843-781-0112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COAXUM",
        "first_name": "KENNASIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-22",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "SC",
            "license": "57100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clemson Sports Medicine and Rehabilitation, Inc (Goose Creek Physical Therapy)
• Tanner Cline
• Coastal Internal Medicine & Geriatrics LLC
• Coastal Therapy Services, Inc.
• Coastal Vision Care LLC
• Monroe Kaylynn Cober
• Joseph Robert Cockrell Jr., M.D.
• Michael J. Colby, PT
• Joseph K Coll
• Jodie F Collier

• Licensed Practical Nurse in Goose Creek, SC
• Providers in Goose Creek, SC by specialty
• Licensed Practical Nurse in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2026; 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.