Coastal Carolina Primary Care, LLC
NPI 1821257676ActiveOrganization· Internal Medicine, Endocrinology, Diabetes & Metabolism· Myrtle Beach, SC
Internal Medicine, Endocrinology, Diabetes & Metabolism in Myrtle Beach, South Carolina, registered in NPPES in June 2008. The authorized official on file is William Tedrick Johnson, Vice President. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1821257676 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 6, 2008 |
| Last updated in NPPES | Dec 29, 2021 |
| Certified by provider | Dec 29, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine, Endocrinology, Diabetes & Metabolism Primary | 207RE0101X | — | — |
| Obstetrics & Gynecology | 207V00000X | — | — |
| Psychiatry & Neurology, Psychiatry | 2084P0800X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (SC) |
|---|
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