Kevin W Shea (NPI# 1265474324, PAC ID# 2466542733) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INFECTIOUS DISEASE.
| Nation Provider ID (NPI) | 1265474324 |
| PAC ID by PECOS | 2466542733 |
| Professional Enrollment ID | I20091229000045 |
| Full Name | Kevin W Shea |
| Organization Legal Name | COASTAL CAROLINA PRIMARY CARE, LLC |
| Address |
8170 Rourk St Suite 100 Myrtle Beach SC 29572-4127 |
| Phone Number | 8432361950 |
| Gender | M |
| Medical School | STATE UNIVERSITY OF NEW YORK - STATE COLLEGE OPTOMETRY |
| Graduation Year | 1991 |
| Primary Specialty | INFECTIOUS DISEASE |
| Group Practice PAC ID | 3577629088 |
| Number of Group Practice Members | 45 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 420085 | GRAND STRAND REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 8170 Rourk St, Suite 100, Myrtle Beach, SC 29572-4127 | 8432361950 | COASTAL CAROLINA PRIMARY CARE, LLC |
| Organization Legal Name | COASTAL CAROLINA PRIMARY CARE, LLC |
| Physicians | 39 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Anthony L Shadiack | Family Medicine | Coastal Carolina Primary Care, LLC | 839 82nd Pkwy, Myrtle Beach, SC 29572-4614 |
| Nancy Burgess Stroud | Obstetrics/gynecology | Coastal Carolina Primary Care, LLC | 9279 Medical Plaza Dr, Suite A, Charleston, SC 29406-9141 |
| Jerry G Back | Internal Medicine | Coastal Carolina Primary Care, LLC | 2845 Tricom St, North Charleston, SC 29406-9172 |
| Alexander W Chessman | Family Medicine | Coastal Carolina Primary Care, LLC | 9228 Medical Plaza Dr, Charleston, SC 29406-9125 |
| Susan K Herrington | Physician Assistant | Coastal Carolina Primary Care, LLC | 9221 University Blvd, Suite 102, North Charleston, SC 29406-9148 |
| Sarah E Hearn | Physician Assistant | Coastal Carolina Primary Care, LLC | 295 Midland Pkwy, Summerville, SC 29485-8104 |
| Nicholas P Shungu | Family Medicine | Coastal Carolina Primary Care, LLC | 809 82nd Pkwy, Myrtle Beach, SC 29572-4607 |
| Sean Patrick Haley | Family Medicine | Coastal Carolina Primary Care, LLC | 9228 Medical Plaza Dr, Charleston, SC 29406-9125 |
| Eric M Matheson | Family Medicine | Coastal Carolina Primary Care, LLC | 9228 Medical Plaza Dr, Charleston, SC 29406-9125 |
| Kristen L Hood Watson | Family Medicine | Coastal Carolina Primary Care, LLC | 9228 Medical Plaza Dr, Charleston, SC 29406-9125 |
| Street Address |
8170 ROURK ST SUITE 100 |
| City | MYRTLE BEACH |
| State | SC |
| Zip | 29572-4127 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Robert J Coni | Neurology | Grand Strand Specialty Associates, LLC | 8170 Rourk St, Suite 150, Myrtle Beach, SC 29572-4127 |
| Mark Grinman | Neurology | Grand Strand Specialty Associates, LLC | 8170 Rourk St, Suite 150, Myrtle Beach, SC 29572-4127 |
| Marissa C Gardache | Physician Assistant | Grand Strand Specialty Associates, LLC | 8170 Rourk St, Suite 150, Myrtle Beach, SC 29572-4127 |
| Amanda C Barber | Physician Assistant | Grand Strand Specialty Associates, LLC | 8170 Rourk St, Suite 150, Myrtle Beach, SC 29572-4127 |
| Christopher G Boullion | Orthopedic Surgery | Grand Strand Specialty Associates, LLC | 8170 Rourk St, Suite 150, Myrtle Beach, SC 29572-4127 |
| Andrea J Chamczuk | Neurosurgery | Select Physical Therapy Holdings Inc | 8170 Rourk St, Myrtle Beach, SC 29572-4127 |
| Rasesh S Sheth | Physician Assistant | Grand Strand Specialty Associates, LLC | 8170 Rourk St, Suite 150, Myrtle Beach, SC 29572-4127 |
| Julie Schexnayder | Physical Therapy | Select Physical Therapy Holdings Inc | 8170 Rourk St, Myrtle Beach, SC 29572-4127 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Daniel Staples | Physical Therapy | Benchmark Healthcare Services LLC | 7955 N Kings Hwy, Suite 330, Myrtle Beach, SC 29572-3056 |
| Paul Vojtek | Physical Therapy | Benchmark Healthcare Services LLC | 7955 N Kings Hwy, Suite 330, Myrtle Beach, SC 29572-3056 |
| Stephen Swygert Ford | Physical Therapy | Benchmark Healthcare Services LLC | 7955 N Kings Hwy, Suite 330, Myrtle Beach, SC 29572-3056 |
| Kara Houston | Physical Medicine and Rehabilitation | Benchmark Healthcare Services LLC | 7955 N Kings Hwy, Suite 330, Myrtle Beach, SC 29572-3056 |
| Steven Goodman | Chiropractic | 9612n Kings Hwy, Myrtle Beach, SC 29572-4006 | |
| Barbie Suggs Anderson | Nurse Practitioner | Beach Urgent Care | 9820 N Kings Hwy, Myrtle Beach, SC 29572-4013 |
| Emily Pond Wright | Nurse Practitioner | Beach Urgent Care | 9820 N Kings Hwy, Myrtle Beach, SC 29572-4013 |
| Stephen Gordon Remine | General Surgery | Beach Urgent Care | 9820 N Kings Hwy, Myrtle Beach, SC 29572-4013 |
| Richard G Snyder | General Practice | Beach Urgent Care | 9820 N Kings Hwy, Myrtle Beach, SC 29572-4013 |
| Bleselda G Paragas | Physician Assistant | Beach Urgent Care | 9820 N Kings Hwy, Myrtle Beach, SC 29572-4013 |
| Find all physicians in zip 29572 | |||
| City | MYRTLE BEACH |
| Zip Code | 29572 |
| Specialty | INFECTIOUS DISEASE |
| City + Specialty | MYRTLE BEACH + INFECTIOUS DISEASE |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.