East Coast Retina, PA

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

26821 Issued in SC

Legal business name

EAST COAST RETINA, PA

Practice address

8609 Montague LN
Myrtle Beach, SC 29588-4504

Phone

(843) 215-3363

Fax

(843) 215-7201

NPI assigned

May 10, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Stephen J Phillips, M.D.

Title

Medical Director

Phone

(843) 215-3363

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316995200000",
    "number": "1730138157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8609 MONTAGUE LN",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295884504",
            "telephone_number": "843-215-3363",
            "fax_number": "843-215-7201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8609 MONTAGUE LN",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295884504",
            "telephone_number": "843-215-3363",
            "fax_number": "843-215-7201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST COAST RETINA, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2011-09-26",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "843-215-3363",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "SC",
            "license": "26821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4339",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Marie Dye
• Zachary Adam Dyer, DO
• Rainece J Eaddy, MD
• Donald Eagerton, M.D.
• Shannon Baker Easingwood, PTA
• Eastern Culture LLC
• Ebanysangel
• Dustin L Eck, MD
• Eckerd Corporation
• Edward F. Eckert Jr., DDS

• Clinic/Center in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2011; 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.