Coastal Carolina Heart, LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

COASTAL CAROLINA HEART, LLC

Practice address

1604 Physicians Dr
Suite 104
Wilmington, NC 28401-7362

Phone

(910) 762-2292

Fax

(910) 762-2208

NPI assigned

Oct 12, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Gary Guidry

Title

Ceo

Phone

(704) 815-7804

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• WILMINGTON HEART CENTER Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Novant Health New Hanover Regional Medical Center LLC

  • Community/Retail Pharmacy
  • Wilmington, NC
  • NPI 1366585200

  Member Of

  NPD member

Locations

Practitioners 1

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

• Damian Brezinski, MD

  • Interventional Cardiology Physician
  • Carolina Beach, NC
  • NPI 1740395029
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249603200000",
    "number": "1932298668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10720 SIKES PL",
            "address_2": "SUITE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282778141",
            "telephone_number": "704-815-7789",
            "fax_number": "888-401-6931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 PHYSICIANS DR",
            "address_2": "SUITE 104",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017362",
            "telephone_number": "910-762-2292",
            "fax_number": "910-762-2208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CAROLINA HEART, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2009-08-07",
        "status": "A",
        "authorized_official_last_name": "GUIDRY",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "704-815-7804",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "470001717",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WILMINGTON HEART CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Coastal Carolina Concierge Service
• Coastal Carolina Eye Clinic PA
• Coastal Carolina Eye Clinic, PA
• Coastal Carolina Foot & Ankle Associates PA
• Coastal Carolina Heart LLC
• Coastal Carolina Neonatology, PLLC
• Coastal Carolina Pathology, PA
• Coastal Carolina Pathology, PA
• Coastal Carolina Radiation Oncology, PLLC
• Coastal Carolina Sedation Associates, LLC

• Medical Specialty Clinic/Center in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Medical Specialty Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2009; 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.