Coastal Podiatry, LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

603 Issued in SC

Legal business name

COASTAL PODIATRY, LLC

Practice address

180 Wingo Way
Suite 101
Mount Pleasant, SC 29464-1810

Phone

(843) 856-5337

Fax

(843) 856-5339

NPI assigned

Dec 12, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Rahn A Ravenell, DPMNPI 1639492473

Title

Partner

Phone

(843) 856-5337

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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

• Rahn Antonio Ravenell, DPM

  • Foot & Ankle Surgery Podiatrist
  • Charleston, SC
  • NPI 1639492473
  NPD Authorized official
• Tamika M Bolden Ravenell, DPM

  • Podiatrist
  • Mount Pleasant, SC
  • NPI 1598924581
  NPD
• Stephen Powell, OD

  • Optometrist
  • Orangeburg, SC
  • NPI 1134192081
  NPD (past)

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

{
    "created_epoch": "1323648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323648000000",
    "number": "1720356231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 WINGO WAY",
            "address_2": "SUITE 101",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294641810",
            "telephone_number": "843-856-5337",
            "fax_number": "843-856-5339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 WINGO WAY",
            "address_2": "SUITE 101",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294641810",
            "telephone_number": "843-856-5337",
            "fax_number": "843-856-5339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL PODIATRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-12",
        "last_updated": "2011-12-12",
        "status": "A",
        "authorized_official_last_name": "RAVENELL",
        "authorized_official_first_name": "RAHN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "843-856-5337",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "SC",
            "license": "603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Coastal Spine & Wellness Family Chiropractic
• Coastal Therapeutics PA
• Coastal Therapy Services, Inc.
• Coastal Therapy Services, Inc.
• Coastal Tides Counseling

• Foot & Ankle Surgery Podiatrist in Mount Pleasant, SC
• Providers in Mount Pleasant, SC by specialty
• Foot & Ankle Surgery Podiatrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2011; 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.