COASTAL CAROLINA PRIMARY CARE, LLC
NPI 1821257676
Internal Medicine - Endocrinology, Diabetes & Metabolism in Myrtle Beach, SC
About Coastal Carolina Primary Care, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
COASTAL CAROLINA PRIMARY CARE, LLC (NPI 1821257676) is a healthcare organization registered as an endocrinology, diabetes & metabolism in Myrtle Beach, South Carolina and active in the NPI registry since June 2008. The organization holds a CLIA Microscopy certificate valid through September 30, 2028, maintains a secondary practice location in North Charleston, and lists William Tedrick Johnson, Vice President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Secondary Practice Location 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Coastal Carolina Primary Care, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
33Medicare enrollment records show 33 clinicians reassign Medicare billing to Coastal Carolina Primary Care, LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 14 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 8
Nearest to this location (20)
See all 33Myrtle Beach, SC 29572
Myrtle Beach, SC 29572
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate for Provider-Performed Microscopy Procedures (PPMP) 42D0943668
Coastal Carolina Primary Care, LLC Dba Summerville Women's Care-Medical Plaza · Charleston, SCFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Coastal Carolina Primary Care, LLC's NPI number?
The NPI number for Coastal Carolina Primary Care, LLC is 1821257676. It was assigned to this organization in the NPPES registry on June 6, 2008.
Where is Coastal Carolina Primary Care, LLC located?
Coastal Carolina Primary Care, LLC is located at 920 Doug White Dr Ste 250, Myrtle Beach, SC 29572. The listed phone number is (843) 236-1950.
What is Coastal Carolina Primary Care, LLC's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.
Is Coastal Carolina Primary Care, LLC enrolled in Medicare?
Yes. Coastal Carolina Primary Care, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Coastal Carolina Primary Care, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 33 clinicians in 8 Medicare specialties reassign their Medicare billing to Coastal Carolina Primary Care, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Obstetrics/Gynecology (14), Family Practice (7) and Internal Medicine (7). Of these, 1 practice at this address and 14 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Coastal Carolina Primary Care, LLC hold a CLIA laboratory certificate?
Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 42D0943668) is associated with this NPI, valid through September 30, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Coastal Carolina Primary Care, LLC accept?
Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina and First Choice Next and 1 other insurer list Coastal Carolina Primary Care, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Coastal Carolina Primary Care, LLC was last updated on December 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Coastal Carolina Primary Care, Llc · NPI 1821257676
Endocrinology, Diabetes & Metabolism organization in Myrtle Beach, South Carolina. Organization record, active in the CMS NPPES registry since June 6, 2008.
## Identity
- **NPI:** 1821257676 (Entity type: Organization)
- **Enumerated:** June 6, 2008
- **Primary specialty:** Internal Medicine - Endocrinology, Diabetes & Metabolism · taxonomy 207RE0101X
- **Organization subpart:** No
- **Authorized official:** William Johnson, VICE PRESIDENT
## Practice location
- **Address:** 920 DOUG WHITE DR STE 250, Myrtle Beach, SC 29572-4181
- **Phone:** (843) 236-1950
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 33 clinicians in 8 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Obstetrics/Gynecology (14), Family Practice (7), Internal Medicine (7); 1 practice at this address and 14 within 10 miles; [full list](https://npiprofile.com/npi/1821257676/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 29, 2021
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1821257676) · Data from the CMS NPPES public registry.