NPIMap

Organization Active NPI

Coastal Carolina Medical Center, Inc.

  • Medicare Defined Swing Bed Hospital Unit
  • Hardeeville, SC
National Provider Identifier
1164458196
Registry record updated Mar 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
HTL-902 Issued in SC
Legal business name
COASTAL CAROLINA MEDICAL CENTER, INC.
Practice address
1000 Medical Center Dr
Hardeeville, SC 29927-3446
Phone
(843) 784-8000
Fax
(843) 784-8001
NPI assigned
Jun 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2022

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

Authorized official

Name
Ron Groteluschen
Title
Cfo
Phone
(843) 784-8076

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X HTL-902 SC Primary

Addresses

Primary practice location

1000 Medical Center Dr
Hardeeville, SC 29927-3446

Mailing address

PO Box 741261
Atlanta, GA 30374-1261
Phone (615) 372-8500

Other names 1

  • Coastal Carolina Hospital-Swing Bed Unit Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address CCD@Direct.Hub4.TenetHealth.com Direct

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647907200000",
    "number": "1164458196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 741261",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303741261",
            "telephone_number": "615-372-8500",
            "fax_number": "615-372-8572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MEDICAL CENTER DR",
            "city": "HARDEEVILLE",
            "state": "SC",
            "postal_code": "299273446",
            "telephone_number": "843-784-8000",
            "fax_number": "843-784-8001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CAROLINA MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A",
        "authorized_official_last_name": "GROTELUSCHEN",
        "authorized_official_first_name": "RON",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "843-784-8076"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "SC",
            "license": "HTL-902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "CCD@Direct.Hub4.TenetHealth.com",
            "affiliation": "N",
            "endpointDescription": "Direct Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1000 Medical Center Dr",
            "city": "Hardeeville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "299273446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Coastal Carolina Hospital-Swing Bed Unit",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Coastal Carolina Hospital-Swing Bed Unit",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 22, 2022; 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.