WACCAMAW DERMATOLOGY, LLC
NPI 1962449181
Dermatology in Myrtle Beach, SC

Q: What is Waccamaw Dermatology, LLC's NPI number?

The NPI number for Waccamaw Dermatology, LLC is 1962449181. It was assigned to this organization in the NPPES registry on May 31, 2006.

Q: What is Waccamaw Dermatology, LLC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Active since May 31, 2006

917 MEDICAL CIRCLE, MYRTLE BEACH, SC 29572(843) 449-0453(843) 282-1910 Get Directions Write a Review

NPPES record last updated: March 22, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Waccamaw Dermatology, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WACCAMAW DERMATOLOGY, LLC (NPI 1962449181) is a healthcare organization registered as a dermatology in Myrtle Beach, South Carolina and active in the NPI registry since May 2006. The organization lists Brandon J. Coakley, Managing Partner, as its authorized official.

NPPES Registry Identity

NPI1962449181

Entity TypeOrganization

Primary Taxonomy207N00000X

Legal Business NameWACCAMAW DERMATOLOGY, LLC

Location Address917 MEDICAL CIRCLEMyrtle Beach, SC 29572

Mailing Address917 Medical CircleMyrtle Beach, SC 29572 · (843) 449-0453 · Fax (843) 282-1910

Phone(843) 449-0453

Fax(843) 282-1910

Organization SubpartNo

Authorized OfficialBrandon J. CoakleyManaging Partner · (843) 449-0453

Enumeration DateMay 31, 2006

Last NPPES UpdateMarch 22, 2022

NPPES CertifiedMarch 22, 2022

✔ NPI 1962449181 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207N00000X

Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

917 MEDICAL CIRCLE, Myrtle Beach, SC 29572

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Other Identifiers 1

MedicaidGP1554SC

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

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, Blue Cross and Blue Shield of NC and more.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)

Waccamaw Dermatology, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 24 clinicians reassign Medicare billing to Waccamaw Dermatology, LLC, which bills Medicare for the services they deliver. Of these, 5 practice at this address and 10 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 4

Nurse Practitioner10

Dermatology7

Pathology4

Micrographic Dermatologic Surgery (MDS)3

Nearest to this location (20)

See all 24

Cameron Clements, FNP

Nurse Practitioner

NPI 1841927225