NPIMap

Organization Active NPI

Coastal Eye Group, P.C.

  • Optician
  • Georgetown, SC
National Provider Identifier
1104128917
Registry record updated Feb 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Legal business name
COASTAL EYE GROUP, P.C.
Practice address
1200 Highmarket St Ste 101
Georgetown, SC 29440-3227
Phone
(843) 546-8421
Fax
(843) 546-1173
NPI assigned
Nov 30, 2010
Organization subpart
Yes
Parent organization
COASTAL EYE GROUP, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 4, 2013

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

Authorized official

Name
Dr. Frank K Sloan Jr., M.D.
Title
President
Phone
(843) 449-7115

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1800X Primary

Addresses

Primary practice location

1200 Highmarket St Ste 101
Georgetown, SC 29440-3227

Mailing address

401 79TH Ave N
Myrtle Beach, SC 29572-4310
Phone (843) 449-7115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110217000523 SC DME Supplier - Physician - OptometristDME Supplier - Optician 2466434717 Practice locations: Georgetown, SC

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Carolinas Center for Si6 organizations share this tax ID, including this one
Part of
Carolinas Center for Si

Other organizations with this tax ID 5

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

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1291075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359936000000",
    "number": "1104128917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 79TH AVE N",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724310",
            "telephone_number": "843-449-7115",
            "fax_number": "843-497-2960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 HIGHMARKET ST STE 101",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294403227",
            "telephone_number": "843-546-8421",
            "fax_number": "843-546-1173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL EYE GROUP, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COASTAL EYE GROUP, P.C.",
        "enumeration_date": "2010-11-30",
        "last_updated": "2013-02-04",
        "status": "A",
        "authorized_official_last_name": "SLOAN",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-449-7115",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2013; 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.