NPIMap

Organization Active NPI

Coastal Carolina Urology Group LLC

  • Urology Physician
  • Hardeeville, SC
National Provider Identifier
1124161682
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
10062233 Issued in SC
Legal business name
COASTAL CAROLINA UROLOGY GROUP LLC
Practice address
1010 Medical Center Dr
Suite 100
Hardeeville, SC 29927-3447
Phone
(843) 342-7607
Fax
(843) 342-7640
NPI assigned
Feb 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Tammy Sue Howe
Title
Billing Supervisor
Phone
(888) 482-4871

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X 10062233 SC Primary

Addresses

Primary practice location

1010 Medical Center Dr
Suite 100
Hardeeville, SC 29927-3447

Mailing address

PO Box 440007
Nashville, TN 37244-0007
Phone (888) 482-4871

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124161682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 440007",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372440007",
            "telephone_number": "888-482-4871",
            "fax_number": "615-261-6052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 MEDICAL CENTER DR",
            "address_2": "SUITE 100",
            "city": "HARDEEVILLE",
            "state": "SC",
            "postal_code": "299273447",
            "telephone_number": "843-342-7607",
            "fax_number": "843-342-7640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CAROLINA UROLOGY GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOWE",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "888-482-4871"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "SC",
            "license": "10062233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hardeeville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.