Coastal Urgent Care & Family Medicine

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

COASTAL URGENT CARE & FAMILY MEDICINE

Practice address

201 Business Center Dr Ste a
Pawleys Island, SC 29585-6522

Phone

(888) 467-1117

Fax

(888) 485-3336

NPI assigned

May 6, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Gerald Francis Congdon, MDNPI 1568446326

Title

Managing Physician

Phone

(888) 467-1117

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 3

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

• Gerald Francis Congdon, MD

  • Family Medicine Physician
  • Pawleys Island, SC
  • NPI 1568446326
  Medicare reassignment NPD Authorized official
• Danielle Olivia Woodley, FNP-C

  • Nurse Practitioner
  • Pawleys Island, SC
  • NPI 1154860369
  Medicare reassignment NPD
• Karyn Longo Congdon

  • Pediatric Physical Therapist
  • Myrtle Beach, SC
  • NPI 1053509182
  NPD

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

{
    "created_epoch": "1210032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445990400000",
    "number": "1467628867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 BUSINESS CENTER DR STE A",
            "city": "PAWLEYS ISLAND",
            "state": "SC",
            "postal_code": "295856522",
            "telephone_number": "888-467-1117",
            "fax_number": "888-485-3336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 BUSINESS CENTER DR STE A",
            "city": "PAWLEYS ISLAND",
            "state": "SC",
            "postal_code": "295856522",
            "telephone_number": "888-467-1117",
            "fax_number": "888-485-3336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL URGENT CARE & FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-06",
        "last_updated": "2015-10-28",
        "status": "A",
        "authorized_official_last_name": "CONGDON",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "FRANCIS",
        "authorized_official_title_or_position": "MANAGING PHYSICIAN",
        "authorized_official_telephone_number": "888-467-1117",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP6613",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Coastal Hearing Center Inc
• Coastal Home Care
• Coastal Med, LLC
• Coastal Physical Therapy Group, LLC
• Coastal Recovery of South Carolina
• Coastal Vision Center Inc
• Kristen Cochran
• Kendall Nicole Cochrane
• Alonzo Jackson Cole III
• Trevor Luke Coleman, DPT

• Clinic/Center in Pawleys Island, SC
• Providers in Pawleys Island, SC by specialty
• Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2015; 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.