Coastal Pediatric Associates, PA

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

18368 Issued in SC

Legal business name

COASTAL PEDIATRIC ASSOCIATES, PA

Practice address

1952 Long Grove Dr
Suite 202
Mount Pleasant, SC 29464-7579

Phone

(843) 284-4262

NPI assigned

Mar 30, 2011

Organization subpart

No

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

Authorized official

Name

Dr. William McLaurin Graham, MD

Title

President

Phone

(843) 573-2535

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Coastal Pediatric Associates3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Coastal Pediatric Associates, P.a.

  • Health Service Psychologist
  • Charleston, SC
  • NPI 1083110019
  NPD tax ID
• Coastal Pediatric Associates, P.a.

  • Pediatrics Physician
  • Charleston, SC
  • NPI 1770700759
  NPD tax ID

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/1152/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1301443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487721600000",
    "number": "1851680896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2051 CHARLIE HALL BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145834",
            "telephone_number": "843-266-4769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1952 LONG GROVE DR",
            "address_2": "SUITE 202",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294647579",
            "telephone_number": "843-284-4262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL PEDIATRIC ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-30",
        "last_updated": "2017-02-22",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "MCLAURIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-573-2535",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "18368",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4716",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4680",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Coastal Dermatology, LLC
• Coastal Early Intervention LLC
• Coastal Family Dentistry
• Coastal Fertility Center
• Coastal Neuropsychology Services, P.a.
• Coastal Podiatry LLC
• Coastal Podiatry, LLC
• Coastal Podiatry, LLC
• Coastal Spine & Wellness Family Chiropractic
• Coastal Therapeutics PA

• Pediatrics Physician in Mount Pleasant, SC
• Providers in Mount Pleasant, SC by specialty
• Pediatrics Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2017; 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.