NPIMap

Organization Active NPI

Coastal Carolina Cardiology, P.a.

  • Cardiovascular Disease Physician
  • Greenville, NC
National Provider Identifier
1306801295
Registry record updated Feb 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
COASTAL CAROLINA CARDIOLOGY, P.A.
Practice address
850 W H Smith Blvd
Greenville, NC 27834-3763
Phone
(252) 758-3211
Fax
(252) 758-1811
NPI assigned
Apr 20, 2006
Last updated
Feb 28, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2008

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

Authorized official

Name
Ms. Karen L Waterfield
Title
Administrative Assistant
Phone
(252) 758-3211

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X NU Primary

Addresses

Primary practice location

850 W H Smith Blvd
Greenville, NC 27834-3763

Mailing address

850 W H Smith Blvd
Greenville, NC 27834-3763
Phone (252) 758-3211

Other identifiers 2

IdentifierTypeStateIssuer
890271QMedicaidNC
0271QOtherNCBCBS

National Provider Directory

National Provider Directory

Locations

702 Wh Smith Blvd
Ste B
Greenville, NC 27834
Phone (252) 758-3211

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204156800000",
    "number": "1306801295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 W H SMITH BLVD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278343763",
            "telephone_number": "252-758-3211",
            "fax_number": "252-758-1811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 W H SMITH BLVD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278343763",
            "telephone_number": "252-758-3211",
            "fax_number": "252-758-1811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CAROLINA CARDIOLOGY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-20",
        "last_updated": "2008-02-28",
        "status": "A",
        "authorized_official_last_name": "WATERFIELD",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "252-758-3211",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890271Q",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0271Q",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

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