NPIMap

Organization Active NPI

Coastal Carolina Centers of Urology and Surgery LLC

  • Ambulatory Surgical Clinic/Center
  • Conway, SC
National Provider Identifier
1932274743
Registry record updated May 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
COASTAL CAROLINA CENTERS OF UROLOGY AND SURGERY LLC
Practice address
822 Farrar Drive
Conway, SC 29526-8747
Phone
(843) 347-9587
Fax
(843) 347-9633
NPI assigned
Nov 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2015

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

Authorized official

Name
Mrs. Virginia A McCurdy
Title
Business Office Manager
Phone
(843) 347-9587

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

822 Farrar Drive
Conway, SC 29526-8747

Mailing address

822 Farrar Dr
Conway, SC 29526-8747
Phone (843) 347-9587

Other identifiers 1

IdentifierTypeStateIssuer
ASC042MedicaidSC

Other names 1

  • Rivertown Surgery Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080609000605 SC Part B Supplier - Ambulatory Surgical Center 7214989359 Practice locations: Conway, SC

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Rivertown Surgery CtrCCN 42C0001045
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432166400000",
    "number": "1932274743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "822 FARRAR DR",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295268747",
            "telephone_number": "843-347-9587",
            "fax_number": "843-347-9633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 FARRAR DRIVE",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295268747",
            "telephone_number": "843-347-9587",
            "fax_number": "843-347-9633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CAROLINA CENTERS OF UROLOGY AND SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2015-05-21",
        "status": "A",
        "authorized_official_last_name": "MCCURDY",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "843-347-9587",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ASC042",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rivertown Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Conway, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2015; 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.