NPIMap

Organization Active NPI

Coastal Carolina Medical Center, Inc.

Doing business as Coastal Carolina Hospital

  • Emergency Medical Services (Emergency Medicine) Physician
  • Hardeeville, SC
National Provider Identifier
1740444967
Registry record updated Mar 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
Legal business name
COASTAL CAROLINA MEDICAL CENTER, INC.
Doing business as
Coastal Carolina Hospital
Practice address
1000 Medical Center Dr
Hardeeville, SC 29927-3446
Phone
(843) 784-8000
NPI assigned
Jul 16, 2008
Last updated
Mar 22, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
COASTAL CAROLINA MEDICAL CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 22, 2022

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

Authorized official

Name
Mr. Ron Groteluschen
Title
Cfo
Phone
(843) 784-8076

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X NU Primary

Addresses

Primary practice location

1000 Medical Center Dr
Hardeeville, SC 29927-3446

Mailing address

PO Box 741261
Atlanta, GA 30374-1261
Phone (615) 372-8500

Other names 1

  • Coastal Carolina Hospital Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address CCD@Direct.Hub4.TenetHealth.com Direct

National Provider Directory

National Provider Directory
Tax ID family
Coastal Carolina Med Ctr2 organizations share this tax ID, including this one
Part of
Coastal Carolina Med Ctr

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1216166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647907200000",
    "number": "1740444967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 741261",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303741261",
            "telephone_number": "615-372-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MEDICAL CENTER DR",
            "city": "HARDEEVILLE",
            "state": "SC",
            "postal_code": "299273446",
            "telephone_number": "843-784-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CAROLINA MEDICAL CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COASTAL CAROLINA MEDICAL CENTER, INC.",
        "enumeration_date": "2008-07-16",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A",
        "authorized_official_last_name": "GROTELUSCHEN",
        "authorized_official_first_name": "RON",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "843-784-8076",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "CCD@Direct.Hub4.TenetHealth.com",
            "affiliation": "N",
            "endpointDescription": "Direct Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1000 Medical Center Dr",
            "city": "Hardeeville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "299273446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Coastal Carolina Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Coastal Carolina Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hardeeville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2022; 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.