Coastal Carolina Physical Rehab Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

MD21577 Issued in SC

Legal business name

COASTAL CAROLINA PHYSICAL REHAB INC

Practice address

235 Singleton Ridge Rd
Suite 108
Conway, SC 29526

Phone

(843) 347-4175

Fax

(843) 347-4179

NPI assigned

Dec 12, 2008

Last updated

Dec 12, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mayra Alfonso, MDNPI 1033298393

Title

Owner

Phone

(843) 347-4175

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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.

• Mayra I Alfonso, MD

  • Physical Medicine & Rehabilitation Physician
  • West Palm Beach, FL
  • NPI 1033298393
  NPD (past) Authorized official

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

{
    "created_epoch": "1229040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229040000000",
    "number": "1932344454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 32217",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "29588",
            "telephone_number": "843-347-4175",
            "fax_number": "843-347-4179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 SINGLETON RIDGE RD",
            "address_2": "SUITE 108",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "29526",
            "telephone_number": "843-347-4175",
            "fax_number": "843-347-4179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CAROLINA PHYSICAL REHAB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-12",
        "last_updated": "2008-12-12",
        "status": "A",
        "authorized_official_last_name": "ALFONSO",
        "authorized_official_first_name": "MAYRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-347-4175",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "SC",
            "license": "MD21577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC MEDICAL LICENSE",
            "identifier": "MD21577",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clinical Pathology Consultants, PA
• Coastal Cancer Center LLC (Coastal Cancer Center)
• Coastal Carolina Centers of Urology and Surgery LLC (Rivertown Surgery Center)
• Coastal Carolina Centers of Urology and Surgery LLC (Rivertown Surgery Center)
• Coastal Carolina OB GYN LLC
• Coastal Carolina University
• Coastal Carolina University Counseling Services
• Coastal Carolina University Student Health Services
• Coastal Family Medicine
• Coastal Home Care (American HomePatient)

• Specialist in Conway, SC
• Providers in Conway, SC by specialty
• Specialist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2008; 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.