Coastal Eye Management LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

1934 Issued in SC

Legal business name

COASTAL EYE MANAGEMENT LLC

Practice address

12060 Highway 17 Byp Unit B
Murrells Inlet, SC 29576-9401

Phone

(843) 357-2020

NPI assigned

Apr 23, 2018

Organization subpart

No

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

Authorized official

Name

Ryan Shake, O.D.NPI 1457707911

Title

Doctor

Phone

(843) 357-2020

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Practitioners 1

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

• Ryan Shake, O.D.

  • Optometrist
  • Myrtle Beach, SC
  • NPI 1457707911
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1524441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1760979066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 LINKS RD",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295755810",
            "telephone_number": "843-357-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12060 HIGHWAY 17 BYP UNIT B",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295769401",
            "telephone_number": "843-357-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL EYE MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-23",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "SHAKE",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "843-357-2020",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "SC",
            "license": "1934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457707911",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Coastal Cancer Center, LLC (Coastal Cancer Center)
• Coastal Carolina Breast Center LLC
• Coastal Carolina Primary Care of Murrells Inlet (Palmetto Internal Medicine)
• Coastal Dental Group LLC
• Coastal Eye Group, P.C.
• Coastal Healthrx LLC
• Coastal House Calls
• Coastal House Calls, PC
• Coastal Palm Orthodontics LLC (Coastal Palm Orthodontics)
• Coastal Prosthetic & Orthotic Laboratory Inc

• Clinic/Center in Murrells Inlet, SC
• Providers in Murrells Inlet, 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 Jun 16, 2018; 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.