Complete Care Medical Group LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

COMPLETE CARE MEDICAL GROUP LLC

Practice address

1413 Highway 17 S
Suite 1200
Surfside Beach, SC 29575-6040

Phone

(843) 631-4656

NPI assigned

Sep 19, 2016

Organization subpart

No

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

Authorized official

Name

Ms. Tina J Lester

Title

Business Manager

Phone

(804) 939-7037

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1474243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474243200000",
    "number": "1982152906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1413 HIGHWAY 17 S",
            "address_2": "SUITE 1200",
            "city": "SURFSIDE BEACH",
            "state": "SC",
            "postal_code": "295756040",
            "telephone_number": "843-631-4656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1413 HIGHWAY 17 S",
            "address_2": "SUITE 1200",
            "city": "SURFSIDE BEACH",
            "state": "SC",
            "postal_code": "295756040",
            "telephone_number": "843-631-4656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE CARE MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-19",
        "last_updated": "2016-09-19",
        "status": "A",
        "authorized_official_last_name": "LESTER",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "804-939-7037",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coastal Podiatry Associates PA
• Coastal Vision Center
• James M Coker, O.D
• Veronica Patricia Collings, D.C.
• Benjamin Hampton Collins, DMD
• Comprehensive Physical Therapy & Rehab
• Conway Hospital, Inc.
• Conway Hospital, Inc.
• Phillip W Corlew, PHARM.D
• William Burwick Cox Jr., DMD

• All providers in Surfside Beach, SC
• Dermatology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2016; 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.