Coastal Rejuvenation Solutions

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

COASTAL REJUVENATION SOLUTIONS

Practice address

630 Chestnut Rd
Myrtle Beach, SC 29572-5502

Phone

(843) 945-1452

Fax

(843) 945-1489

NPI assigned

Aug 1, 2023

Last updated

Aug 1, 2023By 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

Laura C Crawford, MSW

Title

Owner

Phone

(843) 945-1452

Specialties & licenses 7

Addresses

Practitioners 1

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.

• Laura L Crawford, LISW-CP

  • Clinical Social Worker
  • Myrtle Beach, SC
  • NPI 1023604600
  NPD

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

{
    "created_epoch": "1690848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690848000000",
    "number": "1134801160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 CHESTNUT RD",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295725502",
            "telephone_number": "843-945-1452",
            "fax_number": "843-945-1489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 CHESTNUT RD",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295725502",
            "telephone_number": "843-945-1452",
            "fax_number": "843-945-1489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL REJUVENATION SOLUTIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-01",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A",
        "authorized_official_last_name": "CRAWFORD",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-945-1452",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083B0002X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Obesity Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coastal Periodontics LLC (Coastal Periodontics)
• Coastal Podiatry Associates PA
• Coastal Podiatry Associates PA
• Coastal Podiatry Associates, PA
• Coastal Recovery & Wellness, LLC (Coastal Recovery)
• Coastal Renal Care
• Coastal Samaritan Counseling Center
• Coastal Sleep Lab, Inc
• Coastal Springs Counseling LLC
• Coastal Wellness Center, LLC

• Multi-Specialty Clinic/Center in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Multi-Specialty Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; 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.