COASTAL CAROLINA PRIMARY CARE, LLC
NPI 1821257676
Internal Medicine - Endocrinology, Diabetes & Metabolism in Myrtle Beach, SC

Active since June 06, 2008CLIA 42D0943668 · Microscopy
920 DOUG WHITE DR STE 250, MYRTLE BEACH, SC 29572(843) 236-1950 Get Directions Write a Review

NPPES record last updated: December 29, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 29, 2021, Aug 28, 2021 (2 updates tracked since 2021).

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, 2026, maintains a secondary practice location in North Charleston, and lists William Tedrick Johnson, Vice President, as its authorized official.

NPPES Registry Identity

NPI1821257676
Entity TypeOrganization
Primary Taxonomy207RE0101X
Legal Business NameCOASTAL CAROLINA PRIMARY CARE, LLC
Location Address920 DOUG WHITE DR STE 250Myrtle Beach, SC 29572-4181
Mailing Address2000 Health Park DrBrentwood, TN 37027-4692 · (615) 372-5426
Organization SubpartNo
Authorized OfficialWilliam Tedrick JohnsonVice President · (615) 372-3375
Enumeration DateJune 6, 2008
Last NPPES UpdateDecember 29, 20212 updates tracked since enumeration
NPPES CertifiedDecember 29, 2021
NPI 1821257676 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
Definition
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.
Also ListedObstetrics & GynecologyTaxonomy 207V00000X
Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X
920 DOUG WHITE DR STE 250, Myrtle Beach, SC 29572

Secondary Practice Location 1

Location 19221 University Blvd Ste 102North Charleston, SC 29406-9148 · Phone (843) 576-0700 · Fax (866) 302-2249

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

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, SC
Active · expires Sep 30, 2026
CLIA Number42D0943668
Laboratory TypePhysician Office
Certificate Effective DateOctober 1, 2024
Certificate Expiration DateSeptember 30, 2026
Laboratory DirectorDr. Elizabeth N. Dacus
Laboratory Phone(843) 569-2900
Laboratory LocationCoastal Carolina Primary Care, LLC Dba Summerville Women's Care-Medical Plaza9279 Medical Plaza Drive, Suite A, Charleston, SC 29406
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine
920 DOUG WHITE DR STE 250
MYRTLE BEACH, SC 29572
Family Medicine
920 DOUG WHITE DR STE 250
MYRTLE BEACH, SC 29572
Internal Medicine (Infectious Disease)
920 DOUG WHITE DR STE 250
MYRTLE BEACH, SC 29572
Internal Medicine (Geriatric Medicine)
920 DOUG WHITE DR STE 250
MYRTLE BEACH, SC 29572
Internal Medicine
920 DOUG WHITE DR STE 250
MYRTLE BEACH, SC 29572
Family Medicine
920 DOUG WHITE DR STE 250
MYRTLE BEACH, SC 29572
Internal Medicine
920 DOUG WHITE DR STE 250
MYRTLE BEACH, SC 29572
Internal Medicine
920 DOUG WHITE DR STE 250
MYRTLE BEACH, SC 29572

Frequently 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.

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, 2026. 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 from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina, First Choice Next and Molina Healthcare 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.