Coastal Vascular & Vein Center PA

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

COASTAL VASCULAR & VEIN CENTER PA

Practice address

2575 Elms Center Rd Ste 200
N Charleston, SC 29406-9875

Phone

(843) 577-4551

Fax

(843) 577-2227

NPI assigned

Aug 17, 2021

Organization subpart

No

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

Authorized official

Name

Evelyn Carter, CMP, CPM, CHM

Title

Chief Administrative Officer

Phone

(843) 300-3583

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 2

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

• Adam Keefer, M.D.

  • Vascular Surgery Physician
  • Charleston, SC
  • NPI 1396855060
  NPD
• Paul Kevin Beach, M.D.

  • Vascular Surgery Physician
  • Brunswick, GA
  • NPI 1770672982
  NPD (past)

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

{
    "created_epoch": "1629158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629158400000",
    "number": "1548936909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2575 ELMS CENTER RD STE 200",
            "city": "N CHARLESTON",
            "state": "SC",
            "postal_code": "294069875",
            "telephone_number": "843-577-4551",
            "fax_number": "843-577-2227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2575 ELMS CENTER RD STE 200",
            "city": "N CHARLESTON",
            "state": "SC",
            "postal_code": "294069875",
            "telephone_number": "843-577-4551",
            "fax_number": "843-577-2227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL VASCULAR & VEIN CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-17",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "EVELYN",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "843-300-3583",
        "authorized_official_credential": "CMP, CPM, CHM"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DE3876",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany M Clemmons
• Clemson Sports Medicine and Rehabilitation
• Clemson Sports Medicine and Rehabilitation, Inc.
• Clta, LLC
• Coastal Chiropractic Center, LLC
• Coastal Womens Care
• Constance S Cody
• Marissa Collins, DPT
• Concentra Health Services, Inc.
• Mary Celeste Conlon, FNP

• Prosthetic/Orthotic Supplier in N Charleston, SC
• Providers in N Charleston, SC by specialty
• Prosthetic/Orthotic Supplier in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.