Coastal Carolina Physician Practices LLC

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

18548 Issued in SC

Legal business name

COASTAL CAROLINA PHYSICIAN PRACTICES LLC

Practice address

1010 Medical Center Dr
Suite 210
Hardeeville, SC 29927-3447

Phone

(843) 784-7160

Fax

(843) 784-7161

NPI assigned

Mar 20, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Robert Klein

Title

Division President

Phone

(615) 372-8500

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Coastal Carolina Ear Nose and Throat Doing business as

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174648802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 MEDICAL CENTER DR",
            "address_2": "SUITE 210",
            "city": "HARDEEVILLE",
            "state": "SC",
            "postal_code": "299273447",
            "telephone_number": "843-784-7160",
            "fax_number": "843-784-7161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 MEDICAL CENTER DR",
            "address_2": "SUITE 210",
            "city": "HARDEEVILLE",
            "state": "SC",
            "postal_code": "299273447",
            "telephone_number": "843-784-7160",
            "fax_number": "843-784-7161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CAROLINA PHYSICIAN PRACTICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KLEIN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "DIVISION PRESIDENT",
        "authorized_official_telephone_number": "615-372-8500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": "SC",
            "license": "18548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Carolina Ear Nose and Throat",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Coastal Carolina Medical Center, Inc.
• Coastal Carolina Medical Center, Inc.
• Coastal Carolina Medical Center, Inc.
• Coastal Carolina Medical Center, Inc.
• Coastal Carolina Physician Practices LLC
• Coastal Carolina Urology Group LLC
• Coastal Emergency Group, PC
• Coastal Empire Imaging, LLC
• Ronald Paul Collins
• Completemd of SC, LLC

• Otolaryngology Physician in Hardeeville, SC
• Providers in Hardeeville, SC by specialty
• Otolaryngology Physician in South Carolina

• 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.