Coastal Carolina Infectious Disease, LLC

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

Legal business name

COASTAL CAROLINA INFECTIOUS DISEASE, LLC

Practice address

1110 London St Ste 102
Myrtle Beach, SC 29577

Phone

(843) 668-2376

Fax

(843) 748-0613

NPI assigned

Jan 7, 2016

Organization subpart

No

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

Authorized official

Name

Marlene Thornhill

Title

Billing Manager

Phone

(843) 668-2376

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Yama Osmanzai, MD

  • Infectious Disease Physician
  • Myrtle Beach, SC
  • NPI 1376593673
  Medicare reassignment NPD

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

{
    "created_epoch": "1452124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526515200000",
    "number": "1265898191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 LONDON ST STE 102",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295775799",
            "telephone_number": "843-668-2376",
            "fax_number": "843-748-0613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 LONDON ST STE 102",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "29577",
            "telephone_number": "843-668-2376",
            "fax_number": "843-748-0613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CAROLINA INFECTIOUS DISEASE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-07",
        "last_updated": "2018-05-17",
        "status": "A",
        "authorized_official_last_name": "THORNHILL",
        "authorized_official_first_name": "MARLENE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "843-668-2376"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Coastal Care Health Network LLC
• Coastal Carolina Allergy & Asthma Associates, PC
• Coastal Carolina Cosmetic Facial Surgery
• Coastal Carolina Oral Maxillofacial Surgery
• Coastal Carolina Otolaryngology Associates,PA
• Coastal Carolina Primary Care, LLC
• Coastal Center for Cognitive Therapy, PA
• Coastal Dermatology Institute LLC

• Infectious Disease Physician in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Infectious Disease Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2018; 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.