Coastal Dermatology

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

COASTAL DERMATOLOGY

Practice address

400 Commercial CT
Savannah, GA 31406-3648

Phone

(912) 352-3535

Fax

(912) 352-3485

NPI assigned

May 10, 2007

Last updated

Sep 22, 2015By 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

Kathy Hodges

Title

Billing Representative

Phone

(912) 562-7092

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 6

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.

• Josepha Bueno Devaro, M.D.

  • Dermatology Physician
  • Savannah, GA
  • NPI 1295729051
  Medicare reassignment NPD
• Elizabeth Bennett, O.D.

  • Optometrist
  • Savannah, GA
  • NPI 1750818571
  NPD
• Oswald Lightsey Mikell, M.D.

  • MOHS-Micrographic Surgery Physician
  • Hilton Head Island, SC
  • NPI 1669414819

  Dermatology

  NPD
• Henry Alvin Taylor II, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Hinesville, GA
  • NPI 1861590754
  NPD (past)
• Ido Friedman, D.P.M

  • Podiatrist
  • Anderson, SC
  • NPI 1417953886
  NPD (past)
• Carmen Anderson Traywick, MD

  • Dermatology Physician
  • Bluffton, SC
  • NPI 1588841597
  NPD (past)

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442880000000",
    "number": "1730393455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 COMMERCIAL CT",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314063648",
            "telephone_number": "912-352-3535",
            "fax_number": "912-352-3485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 COMMERCIAL CT",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314063648",
            "telephone_number": "912-352-3535",
            "fax_number": "912-352-3485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2015-09-22",
        "status": "A",
        "authorized_official_last_name": "HODGES",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "BILLING REPRESENTATIVE",
        "authorized_official_telephone_number": "912-562-7092"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DF6062",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Coastal Community Health Services, Inc. (Coastal Community Pharmacy #103)
• Coastal Community Health Services, Inc. (Coastal Community Health)
• Coastal Concierge Counseling, LLC
• Coastal Counseling Center, LLC
• Coastal Counseling LLC
• Coastal Ear Nose & Throat, LLC (Coastal Ear Nose & Throat)
• Coastal Ear Nose & Throat, LLC
• Coastal Empire Chiropractic Inc (Bright Life Chiropractic)
• Coastal Empire Orthopedics LLC
• Coastal Empire Surgical Assistants LLC

• Dermatology Physician in Savannah, GA
• Providers in Savannah, GA by specialty
• Dermatology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2015; 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.