Coastal Carolina Anesthesiologist, P.a.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

COASTAL CAROLINA ANESTHESIOLOGIST, P.A.

Practice address

500 Jefferson St
Whiteville, NC 28472-3634

Phone

(910) 642-6427

Fax

(910) 642-5769

NPI assigned

Feb 7, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Robin Zaki Dimitrious, M.D.

Title

President

Phone

(910) 642-6427

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

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

• Francine J D'Ercole, M.D.

  • Anesthesiology Physician
  • Chapel Hill, NC
  • NPI 1639203136
  NPD (past)

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720128044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 505",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284720505",
            "telephone_number": "910-642-6427",
            "fax_number": "910-642-5769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 JEFFERSON ST",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284723634",
            "telephone_number": "910-642-6427",
            "fax_number": "910-642-5769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CAROLINA ANESTHESIOLOGIST, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DIMITRIOUS",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "ZAKI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-642-6427",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC AND BS OF NC",
            "identifier": "015KM",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89015KM",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christy T Perdue MD PA
• Davisha Shaquan Clarida
• Jeffrey Alan Clarke, PA
• Delone Yvette Cleare, O.T.
• Cathy M Cliff, CFM
• Coastal Carolina Behavioral Healthcare LLC
• Coastal Carolina ENT DO PA
• Coastal Carolina Neonatology, PLLC
• Coastal Community Management LLC
• Coastal Comprehensive Care PA

• Anesthesiology Physician in Whiteville, NC
• Providers in Whiteville, NC by specialty
• Anesthesiology Physician in North 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.