DR. BRANDON JAMES COAKLEY (NPI# 1992065858) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992065858 |
| Entity Type | Individual |
| Full Name | DR. BRANDON JAMES COAKLEY |
| Credential | MD |
| Practice Address |
917 Medical Cir Myrtle Beach SC 29572-4116 |
| Practice Telephone | 8434490453 |
| Practice Fax Number | 8434499531 |
| Mailing Telephone | 8434490453 |
| Mailing Fax Number | 8434499531 |
| Enumeration Date | 2012-05-24 |
| Last Update Date | 2019-12-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
MD40685 | SC | Allopathic & Osteopathic Physicians |
| Street Address |
917 MEDICAL CIR |
| City | MYRTLE BEACH |
| State | SC |
| Zip Code | 29572-4116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124556584 | Misty Danelle Polston | Nurse Practitioner | 917 Medical Cir, Myrtle Beach, SC 29572-4116 | 2017-05-30 |
| 1972988590 | Lindsay Marie Johnson | Physician Assistant | 917 Medical Cir, Myrtle Beach, SC 29572-4116 | 2015-07-24 |
| 1245627439 | Michael Xiong | Dermatology | 917 Medical Cir, Myrtle Beach, SC 29572-4116 | 2015-04-25 |
| 1548512619 | Erin Stephanie Coakley | Physician Assistant | 917 Medical Cir, Myrtle Beach, SC 29572-4116 | 2012-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629684576 | Matthew David Zeuschner | Nurse Practitioner | 107 Woodwind Court, Myrtle Beach, SC 29572 | 2020-09-16 |
| 1578191789 | Julia Ruth Nelson | Student in an Organized Health Care Education/Training Program | Grand Strand Medical Center- Gme Office, 809 82nd Parkway, Myrtle Beach, SC 29572 | 2020-04-01 |
| 1407484835 | Justin Schevers | Student in an Organized Health Care Education/Training Program | 802 82nd Parkway, Myrtle Beach, SC 29572 | 2020-03-31 |
| 1922636919 | Darian Michael Quigg | Student in an Organized Health Care Education/Training Program | 809 82nd Street Parkway, Myrtle Beach, SC 29572 | 2020-03-27 |
| 1881221141 | Jonathan Alden Bryan | Student in an Organized Health Care Education/Training Program | Grand Strand Medical Center, 809 82nd Parkway, Myrtle Beach, SC 29572 | 2020-03-26 |
| 1215575238 | Polaris Skin Diagnostics, LLC | Dermatology | 8170 Rourk Street, Suite 100, Myrtle Beach, SC 29572 | 2019-12-20 |
| 1700348711 | Five Star Rehabilitation and Wellness Services, LLC. | Clinic/Center | 9547 N Kings Hwy, Myrtle Beach, SC 29572 | 2019-04-01 |
| 1154882975 | Michael Kouandjio | Student in an Organized Health Care Education/Training Program | Grand Strand Medical Center-gme Office, 809 82nd Parkway, Myrtle Beach, SC 29572 | 2019-03-26 |
| 1154880102 | Dylan Chase Morgan | Internal Medicine | Grand Strand Medical Center - Gme Office, 809 82nd Pkwy, Myrtle Beach, SC 29572 | 2019-03-19 |
| 1710446828 | David Redding Kingery Jr. | Student in an Organized Health Care Education/Training Program | Gme Office 809 82nd Parkway, Myrtle Beach, SC 29572 | 2019-03-18 |
| Find all providers in zip 29572 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174122444 | Coastal Dermatology Institute LLC | Dermatology | 920 Doug White Dr Ste 310, Myrtle Beach, SC 29572-4180 | 2020-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639254014 | Hilton Head Dermatology and Skin Cancer Center Pa | Dermatology | 15 Hospital Center Blvd Ste 1, Hilton Head, SC 29926-2760 | 2006-10-26 |
| 1396777124 | James R Debloom II | Dermatology | 300 Ashby Park Lane, Greenville, SC 29607-6903 | 2006-07-06 |
| 1801825468 | Dermatology Associates of The Lowcountry | Dermatology | 108 Medical Park Dr, Walterboro, SC 29488-5719 | 2006-07-03 |
| 1215989587 | Robert Marshall Rogers | Dermatology | 213 Mills Ave, Greenville, SC 29605-4019 | 2006-05-16 |
| 1083693857 | Carolina Dermatology Grp | Dermatology | 1706 St Julians Place, Columbia, SC 29204-2410 | 2006-01-11 |
| 1427059997 | Richard John Deangelis | Dermatology | 1409 N Fant St, Anderson, SC 29621-4825 | 2005-08-09 |
| 1851810279 | Skin Surgery Center Pa | Dermatology | 180 Wingo Way Ste 202, Mount Pleasant, SC 29464-1811 | 2017-09-18 |
| 1447575931 | Jane Unaeze | Dermatology | 920 Woodruff Rd, Greenville, SC 29607-4105 | 2010-03-29 |
| 1376757427 | Skin Cancer Centre, P. A. | Dermatology | 1409 N Fant St, Anderson, SC 29621-4825 | 2007-05-09 |
| 1417089376 | Germain Dermatology, Pa | Dermatology | 612 Seacoast Pkwy, Suite 201, Mount Pleasant, SC 29464-8247 | 2007-03-09 |
| Find all providers with the same taxonomy | ||||
| City | MYRTLE BEACH |
| Zip Code | 29572 |
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| 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.