Coastal Cancer Care, LLC

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

Legal business name

COASTAL CANCER CARE, LLC

Practice address

4700 Waters Ave
Savannah, GA 31404-6220

Phone

(912) 350-8490

NPI assigned

Dec 12, 2011

Last updated

May 5, 2026By 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

Aaron Pederson, MDNPI 1326211459

Title

Owner

Phone

(912) 350-8490

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• South Georgia Center for Cancer Care, LLC

  dba South Georgia Center for Cancer Care

  • Radiation Oncology Clinic/Center
  • Statesboro, GA
  • NPI 1487180709

  Member Of

  NPD member

Practitioners 7

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.

• Aaron Watson Pederson, MD

  • Radiation Oncology Physician
  • Savannah, GA
  • NPI 1326211459
  Medicare reassignment Care Compare group NPD Authorized official
• Michael D Hasselle, M.D.

  • Radiation Oncology Physician
  • Savannah, GA
  • NPI 1770741928
  Medicare reassignment Care Compare group NPD
• John R Duttenhaver, M.D.

  • Radiation Oncology Physician
  • Savannah, GA
  • NPI 1588695969
  Medicare reassignment NPD
• Kathleen Harden

  • Family Nurse Practitioner
  • Savannah, GA
  • NPI 1093405698
  Medicare reassignment NPD
• Matthew H Bertke, M.D.

  • Radiation Oncology Physician
  • Cincinnati, OH
  • NPI 1083971683

  GA

  Medicare reassignment NPD
• Krystyna D. Kiel, M.D.

  • Radiation Oncology Physician
  • Savannah, GA
  • NPI 1679549349
  NPD (past)
• James Thomas Richardson, MD

  • Radiation Oncology Physician
  • Savannah, GA
  • NPI 1265409072
  NPD (past)

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

{
    "created_epoch": "1323648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777939200000",
    "number": "1205104783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13219",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277093219",
            "telephone_number": "912-350-8490",
            "fax_number": "919-354-2936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 WATERS AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046220",
            "telephone_number": "912-350-8490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CANCER CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-12",
        "last_updated": "2026-05-05",
        "certification_date": "2026-05-05",
        "status": "A",
        "authorized_official_last_name": "PEDERSON",
        "authorized_official_first_name": "AARON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-350-8490",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003135119A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Radiation Oncology Physician in Savannah, GA
• Providers in Savannah, GA by specialty
• Radiation Oncology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2026; 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.