COASTAL WELLNESS CENTER, LLC
NPI 1902077266
Clinic/Center - Primary Care in Myrtle Beach, SC
About Coastal Wellness Center, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
COASTAL WELLNESS CENTER, LLC (NPI 1902077266) is a healthcare organization registered as a primary care in Myrtle Beach, South Carolina and active in the NPI registry since March 2008. The organization holds a CLIA Waiver certificate valid through February 11, 2027, maintains a secondary practice location in Pawleys Island, and lists Gerald Francis Congdon, Managing Physician, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Other Identifiers 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 Wellness Center, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Coastal Wellness Center, LLC, which bills Medicare for the services they deliver. They are listed nearest first.
Clinicians, nearest first (3)
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 of Waiver 42D1084660
Coastal Wellness · Myrtle Beach, 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 Wellness Center, LLC's NPI number?
The NPI number for Coastal Wellness Center, LLC is 1902077266. It was assigned to this organization in the NPPES registry on March 14, 2008.
Where is Coastal Wellness Center, LLC located?
Coastal Wellness Center, LLC is located at 4955 Highway 17 Byp S, Myrtle Beach, SC 29577. The listed phone number is (888) 403-2444.
What is Coastal Wellness Center, LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Coastal Wellness Center, LLC enrolled in Medicare?
Yes. Coastal Wellness Center, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Coastal Wellness Center, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Coastal Wellness Center, LLC, in Family Practice, Nurse Practitioner and Obstetrics/Gynecology. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Coastal Wellness Center, LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 42D1084660) is associated with this NPI, valid through February 11, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Coastal Wellness Center, LLC accept?
Health plans from BlueCross BlueShield of South Carolina, First Choice Next and Molina Healthcare list Coastal Wellness Center, 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 Wellness Center, LLC was last updated on March 6, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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 Wellness Center, Llc · NPI 1902077266
Primary Care organization in Myrtle Beach, South Carolina. Organization record, active in the CMS NPPES registry since March 14, 2008.
## Identity
- **NPI:** 1902077266 (Entity type: Organization)
- **Enumerated:** March 14, 2008
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Gerald Congdon, MANAGING PHYSICIAN
## Practice location
- **Address:** 4955 HIGHWAY 17 BYP S, Myrtle Beach, SC 29577-6684
- **Phone:** (888) 403-2444 · **Fax:** (855) 818-2168
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 3 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (1), Nurse Practitioner (1), Obstetrics/Gynecology (1) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 6, 2019
- **Other identifiers:** Medicaid GP7038 (SC)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1902077266) · Data from the CMS NPPES public registry.