COASTAL CAROLINA PRIMARY CARE, LLC (NPI# 1821257676) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821257676 |
| Entity Type | Organization |
| Organization Name | COASTAL CAROLINA PRIMARY CARE, LLC |
| Practice Address |
9221 University Blvd Ste 102 North Charleston SC 29406-9148 |
| Practice Telephone | 8435760700 |
| Practice Fax Number | 8663022249 |
| Mailing Telephone | 8435760700 |
| Mailing Fax Number | 8663022249 |
| Enumeration Date | 2008-06-06 |
| Last Update Date | 2008-06-06 |
| Authorized Official Name | ANGELA W BRADY (ASST VP OPERATIONS) |
| Authorized Official Telephone | 8438136397 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164783643 | Coastal Carolina Primary Care, LLC | Clinic/Center | 106 W Main St, Moncks Corner, SC 29461-2601 | 2012-05-31 |
| 1942522719 | Coastal Carolina Primary Care, LLC | Family Medicine | 3601 Ladson Rd, Suite 101, Ladson, SC 29456-4304 | 2010-02-22 |
| Street Address |
9221 UNIVERSITY BLVD STE 102 |
| City | NORTH CHARLESTON |
| State | SC |
| Zip Code | 29406-9148 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649746025 | Kimberly Lynn Russell | Physician Assistant | 9221 University Blvd Ste 102, North Charleston, SC 29406-9148 | 2018-10-23 |
| 1114402153 | Brooke Elizabeth Watson | Physician Assistant | 9221 University Blvd Ste 102, North Charleston, SC 29406-9148 | 2018-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023622289 | Sara Desmarais | Physical Therapist | 2760 Tricom St, North Charleston, SC 29406 | 2020-09-04 |
| 1669036448 | Pink Elephant Autism Project | In Home Supportive Care | 8738 Red Oak Drive, Charleston, SC 29406 | 2019-04-26 |
| 1083171185 | Medical University Hospital Authority | Pharmacy | 2250 Mall Drive, North Charleston, SC 29406 | 2019-02-25 |
| 1336627371 | Truesdale Medical Center LLC | Internal Medicine | 6296 Rivers Ave., Suite 310, N. Charleston, SC 29406 | 2018-08-01 |
| 1164914552 | Amanda R Dipiazza | Nurse Anesthetist, Certified Registered | 9330 Medical Plaza Dr Ste E, Charleston, SC 29406 | 2018-06-01 |
| 1982148490 | Trident Medical Center | Psychiatric Hospital | 9225 C Medical Plaza Drive, Charleston, SC 29406 | 2016-12-19 |
| 1649726217 | First Choice Counseling Services, LLC | Community/Behavioral Health | 2245 Greenridge Rd., Unit#414, North Charleston, SC 29406 | 2016-09-01 |
| 1821443896 | Liberty Doctors, LLC | Family Medicine | 9275 D Medical Plaza Dr., North Charleston, SC 29406 | 2016-04-27 |
| 1174984645 | Ashia George | Developmental Therapist | 6650 Rivers Avenue, Ste 100, Charleston, SC 29406 | 2016-03-11 |
| 1023488582 | Etta Smith | Counselor | 2470 Mall Dr Unit Cd, North Charleston, SC 29406 | 2015-09-28 |
| Find all providers in zip 29406 | ||||
| Taxonomy Code | 207RE0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Endocrinology, Diabetes & Metabolism |
| An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700241379 | William Wilson Quick | Internal Medicine | 5402 Overland Trl, Retired From Medical Practice, North Charleston, SC 29420-9024 | 2015-12-23 |
| 1558431874 | Carolina Endocrine Associates, Pa | Internal Medicine | 2831 Tricom St, North Charleston, SC 29406-9172 | 2006-11-08 |
| 1023087962 | Timothy K Gray | Internal Medicine | 2831 Tricom Street, North Charleston, SC 29406-9193 | 2006-03-14 |
| 1639524051 | Carolina Endocrine Associates LLC | Internal Medicine | 2831 Tricom St, Suite A, North Charleston, SC 29406-9193 | 2016-05-04 |
| 1295973873 | Eveline Adams Waring | Internal Medicine | 2831 Tricom St, North Charleston, SC 29406-9193 | 2009-02-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053800821 | I Med Carolinas LLC | Internal Medicine | 105 Stone Village Dr, Fort Mill, SC 29708-6489 | 2018-05-07 |
| 1467992768 | Endocrinology and Diabetes of The Carolinas LLC | Internal Medicine | 901 West Meeting Street, Suite 205, Lancaster, SC 29720 | 2017-03-06 |
| 1205214202 | St Francis Physician Services Inc | Internal Medicine | 2 Innovation Dr Ste 300b, Greenville, SC 29607-5268 | 2015-05-11 |
| 1639584683 | Mc Anto Antony | Internal Medicine | 2000 E Greenville St Ste 3100, Anderson, SC 29621 | 2014-06-29 |
| 1619226842 | Carolina Hormone and Health Center of Charleston | Internal Medicine | 300 W Coleman Blvd Ste 101, Mount Pleasant, SC 29464-5604 | 2012-09-04 |
| 1902118268 | St. Francis Physician Services | Internal Medicine | 2 Innovation Dr Ste 300-b, Greenville, SC 29607-5261 | 2010-07-02 |
| 1750619144 | James Bernard Field | Internal Medicine | 50 Stoney Creek Road, Hilton Head, SC 29928-2909 | 2009-11-24 |
| 1497906432 | Marion E Betancourt Albrecht | Internal Medicine | 901 West Meeting St Suite 205, Lancaster, SC 29720-6209 | 2008-10-08 |
| 1083872030 | Myrtle Beach Endocrinology | Internal Medicine | 1039 44th Avenue North, Suite 204, Myrtle Beach, SC 29577 | 2008-05-27 |
| 1609075928 | Naveed Iqbal | Internal Medicine | 1015 S 4th St, Hartsville, SC 29550-5791 | 2007-07-16 |
| Find all providers with the same taxonomy | ||||
| City | NORTH CHARLESTON |
| Zip Code | 29406 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.