Coastal Carolina Podiatry Inc

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

556 Issued in SC

Legal business name

COASTAL CAROLINA PODIATRY INC

Practice address

4340 Ladson Rd
Suite C
Ladson, SC 29456-6444

Phone

(843) 851-9069

NPI assigned

Aug 8, 2006

Last updated

Feb 20, 2017By 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

William Hal Hatchett, DPMNPI 1083689400

Title

President

Phone

(843) 851-9069

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in SC2 enrollments

Enrollment records 2

Tax ID family

Coastal Carolina Podiatry2 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.

• Coastal Carolina Podiatry Inc

  • Foot & Ankle Surgery Podiatrist
  • Summerville, SC
  • NPI 1629282744
  NPD tax ID

Locations

Practitioners 5

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.

• William Hal Hatchett, DPM

  • Foot & Ankle Surgery Podiatrist
  • Summerville, SC
  • NPI 1083689400
  Medicare reassignment Care Compare group NPD Authorized official
• Edwin Leo Blitch IV, DPM

  • Foot & Ankle Surgery Podiatrist
  • Charleston, SC
  • NPI 1376518795
  Medicare reassignment Care Compare group NPD
• Breelyn Nicole Miles, DPM

  • Podiatrist
  • Ladson, SC
  • NPI 1639664766
  Medicare reassignment Care Compare group NPD
• Vito Speciale, DPM

  • Podiatrist
  • Summerville, SC
  • NPI 1689656498
  Medicare reassignment Care Compare group NPD
• Kathryn Diana Wilson-Horney, DPM

  • Podiatrist
  • Summerville, SC
  • NPI 1073670493
  Medicare reassignment NPD

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487548800000",
    "number": "1154331544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4340 LADSON RD",
            "address_2": "SUITE C",
            "city": "LADSON",
            "state": "SC",
            "postal_code": "294566444",
            "telephone_number": "843-851-9069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4340 LADSON RD",
            "address_2": "SUITE C",
            "city": "LADSON",
            "state": "SC",
            "postal_code": "294566444",
            "telephone_number": "843-851-9069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CAROLINA PODIATRY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2017-02-20",
        "status": "A",
        "authorized_official_last_name": "HATCHETT",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "HAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-851-9069",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "SC",
            "license": "556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PD5561",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DF0094",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caroline Chism, CCC-SLP
• Tanya Chmunevich, CCC-SLP
• Kaitlyn Cingel, SLP
• Samantha Lynn Cliborne, BCBA
• Bailee Cloutier, OTR/L
• Coastal Carolina Primary Care, LLC (Doc At The Door)
• Anthony Coaxum, PHARMD
• Kristi Cockrell
• Jacqueline Cohn, RN
• Jason B Coker, M.D.

• Foot & Ankle Surgery Podiatrist in Ladson, SC
• Providers in Ladson, SC by specialty
• Foot & Ankle Surgery Podiatrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; 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.