COASTAL CAROLINA FOOT & ANKLE ASSOCIATION PA — NPI 1639336027 (Licensed & Credentialed Podiatric Medicine & Surgery Service Providers — Podiatrist, Foot & Ankle Surgery in WALLACE, NC)

CMS-1500 Box 24J / 33a • NPI

1639336027

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

213ES0103X (CMS 48)

Licensed & Credentialed Podiatric Medicine & Surgery Service Providers — Podiatrist, Foot & Ankle Surgery

Box 32 Service Location & ZIP+4

114 N NORWOOD ST, WALLACE, NC, 28466-2730

✓ 9-Digit EDI 837 ZIP+4 (28466-2730)

Practice Phone & Referral Fax

(910) 285-3362

Fax: (910) 285-6683

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1639336027 (COASTAL CAROLINA FOOT & ANKLE ASSOCIATION PA) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1639336027` (NPI-2 Organization / Facility)
Provider / Legal Name	COASTAL CAROLINA FOOT & ANKLE ASSOCIATION PA
Plain-English Specialty	Licensed & Credentialed Podiatric Medicine & Surgery Service Providers — Podiatrist, Foot & Ankle Surgery NUCC Code: `213ES0103X` (Podiatrist, Foot & Ankle Surgery)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	114 N NORWOOD ST, WALLACE, NC, 28466-2730
Practice Telephone / Fax	Tel: (910) 285-3362 \| Fax: (910) 285-6683
Administrative Mailing Address	114 N NORWOOD ST, WALLACE, NC, 28466-2730
Enumeration & Last Sync	Enumerated: 2008-05-22 \| CMS Record Updated: 2013-09-17
Authorized Official	KATHY WALKER (Practice Administrator)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

114 N NORWOOD ST, WALLACE, NC, 28466-2730

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Plain-English Taxonomy & CMS Crosswalk (213ES0103X)

What Does Taxonomy Code 213ES0103X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 213ES0103X translates to:
"Licensed & Credentialed Podiatric Medicine & Surgery Service Providers — Podiatrist, Foot & Ankle Surgery"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 48 (Podiatry)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Podiatrist, Foot & Ankle Surgery for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (COASTAL CAROLINA FOOT & ANKLE ASSOCIATION PA)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`213ES0131X` — Plain English: Licensed & Credentialed Podiatric Medicine & Surgery Service Providers — Podiatrist, Foot Surgery	State: NC \| License: `449` \| Primary: Secondary
`213ES0103X` — Podiatrist, Foot & Ankle Surgery Plain English: Licensed & Credentialed Podiatric Medicine & Surgery Service Providers — Podiatrist, Foot & Ankle Surgery	State: NC \| License: `230` \| Primary: Yes (Primary)

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COASTAL CAROLINA FOOT & ANKLE ASSOCIATION PA (NPI #1639336027)