Coastal Vision Care LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

SC0956 Issued in SC

Legal business name

COASTAL VISION CARE LLC

Practice address

605 Saint James Ave
Goose Creek, SC 29445

Phone

(843) 863-1215

Fax

(843) 553-7335

NPI assigned

Sep 6, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Diane Rosalie Juras, ODNPI 1629026570

Title

Owner

Phone

(843) 693-2505

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Practitioners 4

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.

• Diane Juras, O.D.

  • Optometrist
  • Goose Creek, SC
  • NPI 1629026570
  Medicare reassignment Care Compare group NPD Authorized official
• Erica Ryan Juras, OD

  • Optometrist
  • Charleston, SC
  • NPI 1497284517
  Medicare reassignment Care Compare group NPD
• Wendy Lynn Corrigan, OD

  • Optometrist
  • Mount Pleasant, SC
  • NPI 1932230695
  Medicare reassignment NPD
• Katherine James Kegel, O.D.

  • Optometrist
  • Mount Pleasant, SC
  • NPI 1073602421
  Medicare reassignment NPD

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689777849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23",
            "city": "ISLE OF PALMS",
            "state": "SC",
            "postal_code": "29451",
            "telephone_number": "843-693-2505",
            "fax_number": "843-553-7335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 SAINT JAMES AVE",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "29445",
            "telephone_number": "843-863-1215",
            "fax_number": "843-553-7335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL VISION CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JURAS",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "ROSALIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-693-2505",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "SC",
            "license": "SC0956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DA9726",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D09569",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeannine M Clearman, LMT
• Clemson Sports Medicine and Rehabilitation, Inc (Goose Creek Physical Therapy)
• Tanner Cline
• Coastal Internal Medicine & Geriatrics LLC
• Coastal Therapy Services, Inc.
• Kennasia Coaxum
• Monroe Kaylynn Cober
• Joseph Robert Cockrell Jr., M.D.
• Michael J. Colby, PT
• Joseph K Coll

• Optometrist in Goose Creek, SC
• Providers in Goose Creek, SC by specialty
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.