OrganizationActive
Coastal Wellness Center, LLC
NPI 1902077266 · Primary Care Clinic/Center · Myrtle Beach, SC
Provider details
- NPI number
- 1902077266
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Gerald Congdon, Managing Physician(888) 467-1117
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(92/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 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
4955 Highway 17 Byp S
Myrtle Beach, SC 29577-6684
Phone: (888) 403-2444
Fax: (855) 818-2168
Street-level locationGet directions
Mailing address
4955 Highway 17 Byp S
Myrtle Beach, SC 29577-6684
Additional practice locations (1)
- 201 Business Center Dr Ste BPawleys Island, SC 29585-6522Phone: (888) 467-1117Fax: (888) 990-3903
Registry dates
- Enumerated
- 2008-03-14
- Last updated
- 2019-03-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.