Coastal Cardiovascular Surgery, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

COASTAL CARDIOVASCULAR SURGERY, LLC

Practice address

933 Medical Cir
Myrtle Beach, SC 29572-4116

Phone

(843) 497-7772

Fax

(843) 497-7627

NPI assigned

Nov 30, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Alex Brian McIntyre

Title

Chief Cardiothoracic Surgeon

Phone

(843) 497-7772

Specialties & licenses 1

Addresses

Other identifiers 8

Practitioners 1

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

• Foster Curtis Bryan, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • St Petersburg, FL
  • NPI 1457363103
  NPD (past)

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952385288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 MEDICAL CIR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724116",
            "telephone_number": "843-497-7772",
            "fax_number": "843-497-7627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 MEDICAL CIR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724116",
            "telephone_number": "843-497-7772",
            "fax_number": "843-497-7627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CARDIOVASCULAR SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCINTYRE",
        "authorized_official_first_name": "ALEX",
        "authorized_official_middle_name": "BRIAN",
        "authorized_official_title_or_position": "CHIEF CARDIOTHORACIC SURGEON",
        "authorized_official_telephone_number": "843-497-7772",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7902111",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC LIC F CURTIS BRYAN MD",
            "identifier": "21103",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR GROUP ID",
            "identifier": "C19162",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2303",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T53180",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "790608L",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "790608T",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC LIC A BRIAN MCINTYRE",
            "identifier": "12574",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Specialist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.