Southern Coast Pain Specialists, LLC

Key facts

NPI

1619475274

Entity type

Organization (NPI type 2)

Primary specialty

Pain Medicine (Anesthesiology) Physician 207LP2900X

License

35457 (SC)

Legal business name

SOUTHERN COAST PAIN SPECIALISTS, LLC

Practice address

1000 Pine St W
Varnville, SC 29944-4750

Phone

(843) 476-4702

Fax

(843) 476-4290

NPI assigned

Jan 30, 2018

Organization subpart

Yes

Parent organization (as reported)

SOUTHERN COAST PAIN SPECIALISTS, LLC

Authorized official

Name

Walter B.J. Schuyler, MD NPI 1699936914

Title

Owner

Phone

(843) 476-4702

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

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Southern Coast Pain Specialists Pain Medicine (Anesthesiology) Physician · Beaufort, SC · NPI 1336653708
  NPPES parent name

Practitioners 1

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

• Walter B.J. Schuyler III, M.D. Pain Medicine Physician · Beaufort, SC · NPI 1699936914
  NPD Authorized official

National Provider Directory

Part of

Southern Coast Pain Specialists LLC

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 13, 2019.

{
    "created_epoch": "1517270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550016000000",
    "number": "1619475274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 RIBAUT RD STE 30",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299025447",
            "telephone_number": "843-476-4702",
            "fax_number": "843-476-4290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 PINE ST W",
            "city": "VARNVILLE",
            "state": "SC",
            "postal_code": "299444750",
            "telephone_number": "843-476-4702",
            "fax_number": "843-476-4290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN COAST PAIN SPECIALISTS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHERN COAST PAIN SPECIALISTS, LLC",
        "enumeration_date": "2018-01-30",
        "last_updated": "2019-02-13",
        "status": "A",
        "authorized_official_last_name": "SCHUYLER",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "B.J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-476-4702",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "SC",
            "license": "35457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Varnville, SC

• Willie James Sauls Jr., DDS
• Neal L. Shealy, M.D.
• Sharon Lynn W Shealy, CFNP
• Jeana Smith, RD
• South Carolina Dhec
• Southern Coast Specialists, LLC
• State of South Carolina
• Rebecca Swofford, PA-C
• Theresa H. Taylor
• Deborah Toa, LISW, MSW

All providers in Varnville, SC · Pain Medicine (Anesthesiology) Physician in South Carolina