Coastal Carolinas Integrated Medicine PA
NPI 1649304239 · Pain Medicine (Physical Medicine & Rehabilitation) Physician · Supply, NC
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Coastal Carolinas Integrated Medicine PA is a Pain Medicine (Physical Medicine & Rehabilitation) Physician organization in Supply, NC (NPI 1649304239).
Provider details
- NPI number
- 1649304239
- Entity type
- Organization
- Primary specialty
- Pain Medicine (Physical Medicine & Rehabilitation) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Kenneth Willeford, Owner(910) 755-6060
- License
- 36621 (NC)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 416 Main StNorth Myrtle Beach, SC 29582-3024Phone: (910) 755-6060Fax: (910) 939-1659
Registry dates
- Enumerated
- 2007-03-15
- Last updated
- 2025-07-09
- Certified
- 2025-07-09
Frequently asked questions
- What is Coastal Carolinas Integrated Medicine PA's NPI number?
- Coastal Carolinas Integrated Medicine PA's National Provider Identifier (NPI) is 1649304239, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Coastal Carolinas Integrated Medicine PA?
- Coastal Carolinas Integrated Medicine PA is classified in the NPPES registry as Pain Medicine (Physical Medicine & Rehabilitation) Physician (Allopathic & Osteopathic Physicians).
- Where is Coastal Carolinas Integrated Medicine PA located?
- Coastal Carolinas Integrated Medicine PA's practice location on file with NPPES is 10 Doctors Cir, Supply, NC 28462-4089.
- What is Coastal Carolinas Integrated Medicine PA's phone number?
- The practice phone number listed in the NPPES registry for Coastal Carolinas Integrated Medicine PA is (910) 755-6060.
- Does Coastal Carolinas Integrated Medicine PA accept Medicare?
- Coastal Carolinas Integrated Medicine PA is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Coastal Carolinas Integrated Medicine PA?
- The authorized official listed on Coastal Carolinas Integrated Medicine PA's NPPES record is Kenneth Willeford, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Coastal Carolinas Integrated Medicine PA's NPI active?
- Yes — Coastal Carolinas Integrated Medicine PA's NPI (1649304239) is active in the NPPES registry as of the last update on 2025-07-09.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.