COASTAL CAROLINA RADIATION ONCOLOGY, P.A. (NPI# 1164448130) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164448130 |
| Entity Type | Organization |
| Organization Name | COASTAL CAROLINA RADIATION ONCOLOGY, P.A. |
| Practice Address |
1988 S 16th St Wilmington NC 28401-6647 |
| Mailing Address |
Po Box 4574 Wilmington NC 28406-1574 |
| Practice Telephone | 9102511839 |
| Practice Fax Number | 9102518286 |
| Mailing Telephone | 9102511839 |
| Mailing Fax Number | 9102518286 |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2018-04-12 |
| Authorized Official Name | CHARLES ROGERS NEAL (PRESIDENT) |
| Authorized Official Telephone | 9102511839 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | Other Service Providers | ||
| Y | 261QX0203X |
Clinic/Center Specialization: Oncology, Radiation |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 890103J | 05 | |
| BCBS | 0103J | 01 | |
| NC | 5912071 | 05 | |
| NC | 5921285 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 545 Ocean Hwy W, Supply, NC 284624047 | 9107544716 | 9107544530 |
| 2131 S 17th St, Wilmington, NC 284017407 | 9103423004 | 9103423097 |
| Street Address |
1988 S 16TH ST |
| City | WILMINGTON |
| State | NC |
| Zip Code | 28401-6647 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447234570 | Rex Allison Kiteley II | Radiology | 1988 S 16th St, Wilmington, NC 28401-6647 | 2005-12-02 |
| 1730576455 | Mustafa Abugideiri | Radiology | 1988 S 16th St, Wilmington, NC 28401-6647 | 2015-04-21 |
| 1578981676 | Tiffany Morgan | Radiology | 1988 S 16th St, Wilmington, NC 28401-6647 | 2014-04-04 |
| 1023315611 | Meaghan Rae Scarlett | Physician Assistant | 1988 S 16th St, Wilmington, NC 28401-6647 | 2011-02-17 |
| 1467628644 | Michael Allison Nichols | Radiology | 1988 S 16th St, Wilmington, NC 28401-6647 | 2008-05-07 |
| 1548381080 | Deborah Magnan Brasic | Nurse Practitioner | 1988 S 16th St, Wilmington, NC 28401-6647 | 2007-04-03 |
| 1831118660 | Michael Alex Papagikos | Radiology | 1988 S 16th St, Wilmington, NC 28401-6647 | 2006-07-19 |
| 1043239700 | Charles Rogers Neal | Radiology | 1988 S 16th St, Wilmington, NC 28401-6647 | 2006-07-19 |
| 1013936772 | Martin Benjamin Meyerson | Specialist | 1988 S 16th St, Wilmington, NC 28401-6647 | 2006-07-19 |
| 1457377582 | Patrick David Maguire | Radiology | 1988 S 16th St, Wilmington, NC 28401-6647 | 2006-07-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275002461 | Thrivetothrive, LLC | Physical Therapist | 1606 Physicians Drive, Inside Promina Health, Wilmington, NC 28401 | 2018-11-16 |
| 1841787454 | Kevin Christopher Panebianco | Family Medicine | 1911 S 17th St Ste 130a, Wilmington, NC 28401 | 2018-04-18 |
| 1518472588 | Michelle Bruin | Family Medicine | 415 S. 2nd Street, Wilmington, NC 28401 | 2017-12-12 |
| 1639617343 | Anna Farwell | Behavior Technician | 3904 Oleander Dr. Suite 102, Wilmington, NC 28401 | 2017-02-02 |
| 1588034144 | Dimitri Zivko Pitovski | Allergy & Immunology | 1099 Medical Center Dr Unit 100b, Wilmington, NC 28401 | 2015-09-25 |
| 1629457007 | Megan Havel | Counselor | 1512 E Lakeshore Drive, Wilmington, NC 28401 | 2015-05-19 |
| 1154709251 | Lance Hutchens | Dentist | 1611 Doctors Cir, Wilmington, NC 28401 | 2015-05-11 |
| 1609281161 | Diane Pittman Whitford | Counselor | 313 Walnut St., Wilmington, NC 28401 | 2014-06-24 |
| 1942550728 | Bryan Cole Chalk | Nurse Anesthetist, Certified Registered | 2131 S 17th Street, Wilmington, NC 28401 | 2012-09-19 |
| 1740566546 | Valerie Baars | Pharmacist | 2302 S 17th Street, Wilmington, NC 28401 | 2011-10-25 |
| Find all providers in zip 28401 | ||||
| Taxonomy Code | 261QX0203X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Oncology, Radiation |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467672873 | South Atlantic Radiation Oncology, LLC | Clinic/Center | 545 Ocean Highway West, Supply, NC 28462 | 2007-04-26 |
| 1386926715 | University Radiation Therapy Center | Clinic/Center | 8800 N Tryon St, Charlotte, NC 28262-3300 | 2011-09-12 |
| 1093035628 | Onslow Radiation Oncology LLC | Clinic/Center | 317 Western Blvd, Jacksonville, NC 28546-6338 | 2010-06-05 |
| 1578885406 | Johnston Radiation Oncology LLC | Clinic/Center | 2076 Hwy 42 W, Suite 120, Clayton, NC 27520-5303 | 2010-02-19 |
| 1114159027 | Western Regional Radiation Therapy Center | Clinic/Center | 14 Medical Park Loop, Sylva, NC 28779-5221 | 2009-08-12 |
| 1831331453 | Cancer Center of Davidson County, LLC | Clinic/Center | 107 W Medical Park Dr, Department of Radiation Oncology, Lexington, NC 27292-6851 | 2009-03-27 |
| 1316194871 | Pineville Radiation Therapy Center, LLC | Clinic/Center | 10650 Park Rd, Charlotte, NC 28210-8407 | 2008-08-26 |
| 1164500716 | Sampson Regional Medical Center | Clinic/Center | 215 Beaman Street, Clinton, NC 28328 | 2006-11-01 |
| City | WILMINGTON |
| Zip Code | 28401 |
Please comment or provide details below to improve the information on COASTAL CAROLINA RADIATION ONCOLOGY, P.A..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.