NPIMap

Organization Active NPI

Coastal Therapy Services, Inc.

  • Speech-Language Pathologist
  • Mt Pleasant, SC
National Provider Identifier
1285641308
Registry record updated Jun 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
COASTAL THERAPY SERVICES, INC.
Practice address
1127 Queensborough Blvd Ste 104
Mt Pleasant, SC 29464-5431
Phone
(843) 216-0290
Fax
(843) 216-2445
NPI assigned
Aug 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2015

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

Authorized official

Name
Ron Thayer, CCC-SLP
Title
Owner
Phone
(843) 216-0290

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

1127 Queensborough Blvd Ste 104
Mt Pleasant, SC 29464-5431

Mailing address

PO Box 1753
Mt Pleasant, SC 29465-1753
Phone (843) 216-0290

Other identifiers 1

IdentifierTypeStateIssuer
GP3250MedicaidSC

National Provider Directory

National Provider Directory
Tax ID family
Coastal Therapy Services Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

120 Springhall Dr
#C
Goose Creek, SC 29445
Phone (843) 216-0290

1127 Queensborough Blvd
Mt Pleasant, SC 29464
Phone (843) 216-0290

Practitioners & affiliated clinicians

Practitioners 36

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

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435017600000",
    "number": "1285641308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1753",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294651753",
            "telephone_number": "843-216-0290",
            "fax_number": "843-216-2445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 QUEENSBOROUGH BLVD STE 104",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294645431",
            "telephone_number": "843-216-0290",
            "fax_number": "843-216-2445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL THERAPY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-02",
        "last_updated": "2015-06-23",
        "status": "A",
        "authorized_official_last_name": "THAYER",
        "authorized_official_first_name": "RON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-216-0290",
        "authorized_official_credential": "CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3250",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2015; 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.