Coastal Carolina Radiology, PLLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

COASTAL CAROLINA RADIOLOGY, PLLC

Practice address

1144 N Road St
Hwy 17N
Elizabeth City, NC 27909-3353

Phone

(252) 384-4615

Fax

(252) 384-4684

NPI assigned

Dec 17, 2007

Organization subpart

No

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

Authorized official

Name

William Jefferson Beavers, M.D.NPI 1376651547

Title

Member

Phone

(252) 384-4615

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 4

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

• William Jefferson Beavers, MD

  • Diagnostic Radiology Physician
  • Greenville, NC
  • NPI 1376651547
  NPD (past) Authorized official
• James Arthur Hunter, MD

  • Diagnostic Radiology Physician
  • Greenville, NC
  • NPI 1104897396
  NPD (past)
• George Lee Jordan III, DO

  • Diagnostic Radiology Physician
  • Greenville, NC
  • NPI 1023197126
  NPD (past)
• Annapurna C. Rao, MD

  • Diagnostic Radiology Physician
  • Brockton, MA
  • NPI 1275648131
  NPD (past)

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

{
    "created_epoch": "1197849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209340800000",
    "number": "1306029004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12017",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236122017",
            "telephone_number": "757-867-6101",
            "fax_number": "757-867-6588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1144 N ROAD ST",
            "address_2": "HWY 17N",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279093353",
            "telephone_number": "252-384-4615",
            "fax_number": "252-384-4684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CAROLINA RADIOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-17",
        "last_updated": "2008-04-28",
        "status": "A",
        "authorized_official_last_name": "BEAVERS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "JEFFERSON",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "252-384-4615",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5908639",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "019YN",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• CNC/Access, Inc.
• CNC/Access, Inc.
• CNC/Access, Inc.
• CNC/Access, Inc.
• CNC/Access, Inc.
• Coastal Eye Center PLLC
• Coastal Prosthetics and Orthotics, LLC
• Coastal Rehabilitation Inc
• Coastal Rehabilitation Inc
• Coastal Rehabilitation Inc

• Diagnostic Radiology Physician in Elizabeth City, NC
• Providers in Elizabeth City, NC by specialty
• Diagnostic Radiology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2008; 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.