Coastal Internal Medicine & Geriatrics LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

33988 Issued in SC

Legal business name

COASTAL INTERNAL MEDICINE & GERIATRICS LLC

Practice address

597 Old Mount Holly Rd
Ste 202
Goose Creek, SC 29445-2831

Phone

(843) 466-8000

NPI assigned

Apr 16, 2017

Organization subpart

No

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

Authorized official

Name

Madhavi Akkineni, M.D.NPI 1477873354

Title

Owner

Phone

(843) 466-8000

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/16032/brand/1/csg/1/fhir/r4

Practitioners 1

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

• Madhavi Akkineni, M.D.

  • Internal Medicine Physician
  • Goose Creek, SC
  • NPI 1477873354
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1492300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492300800000",
    "number": "1265966337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "597 OLD MOUNT HOLLY RD",
            "address_2": "STE 202",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294452831",
            "telephone_number": "843-466-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "597 OLD MOUNT HOLLY RD",
            "address_2": "STE 202",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294452831",
            "telephone_number": "843-466-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL INTERNAL MEDICINE & GERIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-16",
        "last_updated": "2017-04-16",
        "status": "A",
        "authorized_official_last_name": "AKKINENI",
        "authorized_official_first_name": "MADHAVI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-466-8000",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "33988",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "SC",
            "license": "33988",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Goose Creek, SC
• Providers in Goose Creek, SC by specialty
• Internal Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.