NPIMap

Organization Active NPI

Coastal Anesthesia Associates, LLC

  • Anesthesiology Physician
  • Charleston, SC
National Provider Identifier
1942252176
Registry record updated Jul 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
COASTAL ANESTHESIA ASSOCIATES, LLC
Practice address
14 Broughton Rd
Charleston, SC 29407-7529
Phone
(843) 553-7070
Fax
(843) 553-2223
NPI assigned
May 16, 2006
Last updated
Jul 20, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2012

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

Authorized official

Name
Dr. Randall E Kerns, M.D.NPI 1578512828
Title
Owner
Phone
(843) 442-2486

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

14 Broughton Rd
Charleston, SC 29407-7529

Mailing address

PO Box 1465
Ladson, SC 29456-1465
Phone (843) 553-7070

Other identifiers 2

IdentifierTypeStateIssuer
GP3306MedicaidSC
CJ4348OtherSCRR MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031110000173 SC Part B Supplier - Clinic/Group Practice 9032022744 Receives reassigned benefits from 77 practitioners
Practice locations: Summerville, SC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 77

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 77

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342742400000",
    "number": "1942252176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1465",
            "city": "LADSON",
            "state": "SC",
            "postal_code": "294561465",
            "telephone_number": "843-553-7070",
            "fax_number": "843-553-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 BROUGHTON RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294077529",
            "telephone_number": "843-553-7070",
            "fax_number": "843-553-2223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL ANESTHESIA ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2012-07-20",
        "status": "A",
        "authorized_official_last_name": "KERNS",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-442-2486",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3306",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CJ4348",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.