NPIMap

Organization Active NPI

Coastal Healthcare Resources Inc

  • Anesthesiology Physician
  • Florence, SC
National Provider Identifier
1467635128
Registry record updated Jan 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
COASTAL HEALTHCARE RESOURCES INC
Practice address
1807 W Evans St Ste C
Florence, SC 29501-3374
Phone
(866) 877-2762
Fax
(866) 992-7144
NPI assigned
Dec 17, 2007
Last updated
Jan 13, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2021

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

Authorized official

Name
Dr. Gerald C Hamrick Jr., MDNPI 1700865458
Title
Ceo
Phone
(866) 877-2762

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NU
Registered Nurse 163W00000X NU
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

1807 W Evans St Ste C
Florence, SC 29501-3374

Mailing address

PO Box 6467
Florence, SC 29502-6467
Phone (866) 877-2762

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC, TN, AL4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20080225000004 SC Part B Supplier - Clinic/Group Practice 1658283593 Receives reassigned benefits from 95 practitioners
Practice locations: Murrells Inlet, SC; Seneca, SC; Kingstree, SC; Greenville, SC; Florence, SC; Cades, SC; Columbia, SC
O20090929000052 NC Part B Supplier - Clinic/Group Practice 1658283593 Receives reassigned benefits from 40 practitioners
Practice locations: Charlotte, NC; Florence, SC; Greenville, NC; Lumberton, NC; New Bern, NC; Raleigh, NC; Whiteville, NC
O20130719000048 TN Part B Supplier - Clinic/Group Practice 1658283593 Receives reassigned benefits from 14 practitioners
Practice locations: Memphis, TN; Gallatin, TN; Cookeville, TN
O20220118001660 AL Part B Supplier - Clinic/Group Practice 1658283593 Receives reassigned benefits from 5 practitioners
Practice locations: Montgomery, AL

National Provider Directory

National Provider Directory

Locations

236 W Main St
Danville, KY 40422

1140 Lexington Rd
#200
Georgetown, KY 40324
Phone (502) 867-2155

3475 Richmond Rd
#510
Lexington, KY 40509

2400 Eastpoint Pkwy
#510
Louisville, KY 40223

400 University Dr
Prestonsburg, KY 41653
Phone (606) 886-7904

970 Newman Rd
New Bern, NC 28562
Phone (252) 633-9262

3031 New Bern Ave
Ste 200
Raleigh, NC 27610
Phone (919) 747-7820

3555 N Williamsburg County Hwy
Cades, SC 29518
Phone (843) 210-5000

1735 Taylor St
Columbia, SC 29201
Phone (803) 254-3452

1807 W Evans St
Ste C
Florence, SC 29501
Phone (843) 679-3251

309 W Pine St
Florence, SC 29501
Phone (843) 662-4524

322 Union Station Dr
Unit 202
Seneca, SC 29678
Phone (855) 654-2020

2370 Quinland Lake Rd
Ste 150
Cookeville, TN 38506
Phone (931) 201-9682

Practitioners & affiliated clinicians

Practitioners 183

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.

View all 183

NPI Registry JSON

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

{
    "created_epoch": "1197849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610496000000",
    "number": "1467635128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6467",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295026467",
            "telephone_number": "866-877-2762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1807 W EVANS ST STE C",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295013374",
            "telephone_number": "866-877-2762",
            "fax_number": "866-992-7144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL HEALTHCARE RESOURCES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-17",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A",
        "authorized_official_last_name": "HAMRICK",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "866-877-2762",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2021; 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.