NPIMap

Organization Active NPI

Coastal Eye Group, P.C.

  • Ophthalmology Physician
  • Murrells Inlet, SC
National Provider Identifier
1821142266
Registry record updated Feb 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
COASTAL EYE GROUP, P.C.
Practice address
4055 Hwy 17 South
Murrells Inlet, SC 29576
Phone
(843) 652-3937
Fax
(843) 652-3939
NPI assigned
Jan 23, 2007
Last updated
Feb 19, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2009

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

Authorized official

Name
Mrs. Carol L. Rateliff
Title
Office Manager
Phone
(843) 652-3937

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X Primary

Addresses

Primary practice location

4055 Hwy 17 South
Murrells Inlet, SC 29576

Mailing address

4055 Hwy 17 South
Murrells Inlet, SC 29576
Phone (843) 652-3937

Other identifiers 1

IdentifierTypeStateIssuer
GP3709MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040602000514 SC Part B Supplier - Clinic/Group Practice 2466434717 Receives reassigned benefits from 12 practitioners
1 other NPI on this enrollment
Practice locations: Murrells Inlet, SC

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Coastal Eye Group PC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

4055 Highway 17
Murrells Inlt, SC 29576
Phone (843) 652-3937

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235001600000",
    "number": "1821142266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4055 HWY 17 SOUTH",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "29576",
            "telephone_number": "843-652-3937",
            "fax_number": "843-652-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4055 HWY 17 SOUTH",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "29576",
            "telephone_number": "843-652-3937",
            "fax_number": "843-652-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL EYE GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2009-02-19",
        "status": "A",
        "authorized_official_last_name": "RATELIFF",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "843-652-3937",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3709",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrells Inlet, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2009; 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.