Coastal Carolina Heart LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

COASTAL CAROLINA HEART LLC

Doing business as

Wilmington Heart Center

Practice address

1604 Physicians Dr
Suite 104
Wilmington, NC 28401-7362

Phone

(910) 762-2292

Fax

(910) 762-2208

NPI assigned

Apr 1, 2008

Last updated

Apr 8, 2009By 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

Mr. Gary Guidry

Title

Ceo

Phone

(704) 708-6610

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• WILMINGTON HEART CENTER Doing business as

Locations

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

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239148800000",
    "number": "1245402064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10720 SIKES PL",
            "address_2": "SUITE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282778141",
            "telephone_number": "704-708-6610",
            "fax_number": "888-401-6931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 PHYSICIANS DR",
            "address_2": "SUITE 104",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017362",
            "telephone_number": "910-762-2292",
            "fax_number": "910-762-2208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CAROLINA HEART LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-01",
        "last_updated": "2009-04-08",
        "status": "A",
        "authorized_official_last_name": "GUIDRY",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "704-708-6610",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD NC",
            "identifier": "016N9",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WILMINGTON HEART CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Coastal Carolina Concierge Service
• Coastal Carolina Concierge Service
• Coastal Carolina Eye Clinic PA
• Coastal Carolina Eye Clinic, PA
• Coastal Carolina Foot & Ankle Associates PA
• Coastal Carolina Heart, LLC (Wilmington Heart Center)
• Coastal Carolina Neonatology, PLLC
• Coastal Carolina Pathology, PA
• Coastal Carolina Pathology, PA
• Coastal Carolina Radiation Oncology, PLLC

• Medical Specialty Clinic/Center in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Medical Specialty Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2009; 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.