Atlantic Coast Pain Specialists, Inc

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

ATLANTIC COAST PAIN SPECIALISTS, INC

Practice address

2767 Cultra Rd
Conway, SC 29526-3716

Phone

(843) 438-8470

Fax

(843) 438-8480

NPI assigned

Mar 4, 2015

Organization subpart

No

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

Authorized official

Name

Richard Blake Kline, MDNPI 1902824378

Title

Owner

Phone

(843) 438-8470

Specialties & licenses 7

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 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

Locations

Practitioners 5

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

• Richard Blake Kline, MD

  • Pain Medicine (Anesthesiology) Physician
  • Conway, SC
  • NPI 1902824378

  Anesthesiology, SC

  Medicare reassignment Care Compare group NPD Authorized official
• Brian D. Forbus, PA-C

  • Medical Physician Assistant
  • Conway, SC
  • NPI 1225103302

  SC

  Medicare reassignment Care Compare group
• Miriam Iskandar Overholser, PA-C

  • Physician Assistant
  • Conway, SC
  • NPI 1558950030

  SC

  Medicare reassignment
• Nicholas Sottile

  • Physician Assistant
  • Conway, SC
  • NPI 1316593668

  SC

  Medicare reassignment
• Ashleigh Hotaling

  • Family Nurse Practitioner
  • Little River, SC
  • NPI 1538625876
  NPD (past)

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

{
    "created_epoch": "1425427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650412800000",
    "number": "1629460381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2767 CULTRA RD",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295263716",
            "telephone_number": "843-438-8470",
            "fax_number": "843-438-8480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2767 CULTRA RD",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295263716",
            "telephone_number": "843-438-8470",
            "fax_number": "843-438-8480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC COAST PAIN SPECIALISTS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-04",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A",
        "authorized_official_last_name": "KLINE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "BLAKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-438-8470",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "SC",
            "license": "20364",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203648",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Conway, SC
• Pain Medicine (Anesthesiology) Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.