Individual provider Active NPI

Brooke Brown Coyne, AGPCNP-BC

  • Nurse Practitioner
  • North Charleston, SC
National Provider Identifier
1821495425
Registry record updated Mar 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
19166 Issued in SC
Practice address
2070 Northbrook Blvd
Suite A20
North Charleston, SC 29406-9252
Phone
(803) 236-8210
NPI assigned
Nov 25, 2014
Last updated
Mar 27, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 19166 SC Primary

Addresses

Primary practice location

2070 Northbrook Blvd
Suite A20
North Charleston, SC 29406-9252

Mailing address

2070 Northbrook Blvd
Suite A20
North Charleston, SC 29406-9252
Phone (803) 236-8210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150206001529 SC Practitioner - Nurse Practitioner 5991020349 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19166SCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Beaufort Jasper Hampton Comprehensive Health Services, Inc CurrentSince Sep 25, 2018 Accepting new patients
Beaufort Jasper Hampton Comprehensive Health Services, Inc. CurrentSince Sep 25, 2018 Accepting new patients

Locations

721 Okatie Hwy
Okatie, SC 29909

721 Okatie Hwy
#170
Okatie, SC 29909

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EICIBD

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1416873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459036800000",
    "number": "1821495425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2070 NORTHBROOK BLVD",
            "address_2": "SUITE A20",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069252",
            "telephone_number": "803-236-8210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2070 NORTHBROOK BLVD",
            "address_2": "SUITE A20",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069252",
            "telephone_number": "803-236-8210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COYNE",
        "first_name": "BROOKE",
        "middle_name": "BROWN",
        "name_prefix": "Miss",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-25",
        "last_updated": "2016-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "19166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

Verify at the official NPI Registry.