NPIMap

Organization Active NPI

Coastal Cancer Center LLC

Doing business as Coastal Cancer Center

  • Hematology & Oncology Physician
  • Myrtle Beach, SC
National Provider Identifier
1881614170
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
COASTAL CANCER CENTER LLC
Doing business as
Coastal Cancer Center
Practice address
8121 Rourk St
Myrtle Beach, SC 29572-4128
Phone
(843) 692-5000
Fax
(843) 692-5015
NPI assigned
Jul 20, 2006
Last updated
Sep 8, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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

Authorized official

Name
Dr. Vijay Paudel, MDNPI 1972596484
Title
President
Phone
(843) 692-5000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Hematology & Oncology Physician 207RH0003X Primary
Radiation Oncology Physician 2085R0001X

Addresses

Primary practice location

8121 Rourk St
Myrtle Beach, SC 29572-4128

Mailing address

8121 Rourk St
Myrtle Beach, SC 29572-4128
Phone (843) 692-5000

Other practice location 1

4708 Oleander Dr
Myrtle Beach, SC 29577-5742
Phone (843) 449-9415

Other practice location 2

8059 Myrtle Trace Dr
Conway, SC 29526-8946
Phone (843) 692-5000

Other practice location 3

4600 Wild Iris Dr
Myrtle Beach, SC 29577
Phone (843) 449-9415

Other identifiers 4

IdentifierTypeStateIssuer
PG1908MedicaidSC
7902484MedicaidNC
PG1907MedicaidSC
PA8189MedicaidSC

Other names 1

  • COASTAL CANCER CENTER Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031113000696 SC Part B Supplier - Clinic/Group Practice 1456265503 Receives reassigned benefits from 23 practitioners
3 other NPIs on this enrollment
Practice locations: Loris, SC; Myrtle Beach, SC; Conway, SC; Murrells Inlet, SC
O20100930056042 SC DME Supplier - Physician - Hematology/OncologyDME Supplier - Pharmacy 1456265503 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Myrtle Beach, SC

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 4

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D2292319Coastal Cancer Center, LLC8059 Myrtle Trace Drive, Conway, SC 29526Certificate of waiverOct 23, 2027

National Provider Directory

National Provider Directory

Locations

3008 Bayboro St
Loris, SC 29569
Phone (843) 756-0932

Practitioners & affiliated clinicians

Practitioners 23

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 23

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757289600000",
    "number": "1881614170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8121 ROURK ST",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724128",
            "telephone_number": "843-692-5000",
            "fax_number": "843-692-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8121 ROURK ST",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724128",
            "telephone_number": "843-692-5000",
            "fax_number": "843-692-5015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4708 Oleander Dr",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295775742",
            "country_code": "US",
            "telephone_number": "843-449-9415",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8059 Myrtle Trace Dr",
            "address_purpose": "LOCATION",
            "city": "Conway",
            "state": "SC",
            "postal_code": "295268946",
            "country_code": "US",
            "telephone_number": "843-692-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4600 Wild Iris Dr",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "29577",
            "country_code": "US",
            "telephone_number": "843-449-9415",
            "fax_number": "843-449-2160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COASTAL CANCER CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A",
        "authorized_official_last_name": "PAUDEL",
        "authorized_official_first_name": "VIJAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-692-5000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PG1908",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7902484",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PG1907",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA8189",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COASTAL CANCER CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.