| Tidelands Health Family Medicine | |
|
2347 S Highway 17 Murrells Inlet SC 29576-7611 | |
| (843) 357-2443 | |
| (843) 357-2132 |
| Full Name | Tidelands Health Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 2347 S Highway 17, Murrells Inlet, South Carolina |
| Authorized Official Name and Position | Elizabeth Sutherland Ward (EVP & CFO) |
| Authorized Official Contact | 8435277102 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tidelands Health Family Medicine Po Box 421718 Georgetown SC 29442-4203 Ph: (843) 520-8883 | Tidelands Health Family Medicine 2347 S Highway 17 Murrells Inlet SC 29576-7611 Ph: (843) 357-2443 |
| NPI Number | 1235475930 |
|---|---|
| Provider Enumeration Date | 12/27/2012 |
| Last Update Date | 05/01/2020 |
| Medicare PECOS PAC ID | 2365697398 |
|---|---|
| Medicare Enrollment ID | O20130225000067 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235475930 | NPI | - | NPPES |
| GP6126 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | William J Epperson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740277508 PECOS PAC ID: 8820900343 Enrollment ID: I20031104000047 |
| Provider Name | George Albert Wilkinson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790787406 PECOS PAC ID: 4587568969 Enrollment ID: I20031126000412 |
| Provider Name | James D Givens |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1750398525 PECOS PAC ID: 2062307754 Enrollment ID: I20040220000505 |
| Provider Name | Mark E Triana |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1689647588 PECOS PAC ID: 9234025925 Enrollment ID: I20040227000760 |
| Provider Name | Jill Aiken |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1376597666 PECOS PAC ID: 4385611425 Enrollment ID: I20040916000751 |
| Provider Name | David K Haseltine |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396747820 PECOS PAC ID: 5799752861 Enrollment ID: I20040916001011 |
| Provider Name | Michael M Mccaffrey |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1902863103 PECOS PAC ID: 1052372505 Enrollment ID: I20041019001036 |
| Provider Name | Lucretia Ann Carter |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1881642817 PECOS PAC ID: 7618939588 Enrollment ID: I20041102001000 |
| Provider Name | Carol Ann Bogdan |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1033102538 PECOS PAC ID: 6608831979 Enrollment ID: I20041129000380 |
| Provider Name | Lori A Hess |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750344818 PECOS PAC ID: 7113977588 Enrollment ID: I20050125000220 |
| Provider Name | Valerie Lasry |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1750353272 PECOS PAC ID: 9335122027 Enrollment ID: I20051012000023 |
| Provider Name | Amy C Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972547362 PECOS PAC ID: 5395758361 Enrollment ID: I20060714000112 |
| Provider Name | Lawrence C Mann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801800990 PECOS PAC ID: 0446206239 Enrollment ID: I20061212000514 |
| Provider Name | Henry Adkins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578669297 PECOS PAC ID: 9436151438 Enrollment ID: I20070205000142 |
| Provider Name | Thomas Eugene Crosby |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285641175 PECOS PAC ID: 8123120961 Enrollment ID: I20070228000210 |
| Provider Name | Sara Adams |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043397391 PECOS PAC ID: 7315044328 Enrollment ID: I20070525000001 |
| Provider Name | Sheree D Nwanegwo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487610382 PECOS PAC ID: 4981705217 Enrollment ID: I20070731000041 |
| Provider Name | Salim G Ghorra |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1336143908 PECOS PAC ID: 8820179880 Enrollment ID: I20080115000883 |
| Provider Name | Alexander V Duvall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851323448 PECOS PAC ID: 1557449311 Enrollment ID: I20080418000214 |
| Provider Name | Crystal D Cates |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1346419389 PECOS PAC ID: 7214006295 Enrollment ID: I20080516000188 |
| Provider Name | Luis Chastain |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1467477661 PECOS PAC ID: 7517036049 Enrollment ID: I20080522000720 |
| Provider Name | William Whiteside |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1780694588 PECOS PAC ID: 6002981743 Enrollment ID: I20080815000039 |
| Provider Name | David Lee Milling |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1184712093 PECOS PAC ID: 0345315438 Enrollment ID: I20080825000624 |
| Provider Name | Newton Brackett |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1083658025 PECOS PAC ID: 0345147773 Enrollment ID: I20081119000804 |
| Provider Name | Lamberto S Paragas |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1194727057 PECOS PAC ID: 1951461953 Enrollment ID: I20081120000618 |
| Provider Name | James E Turek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942360672 PECOS PAC ID: 7618906280 Enrollment ID: I20081120000760 |
| Provider Name | Gretchen Anne Meyer |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1376598227 PECOS PAC ID: 8628089877 Enrollment ID: I20090121000371 |
| Provider Name | Gerald E Harmon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821073321 PECOS PAC ID: 9537226220 Enrollment ID: I20090325000095 |
| Provider Name | John K Ijem |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1457353138 PECOS PAC ID: 3577603612 Enrollment ID: I20091221000408 |
| Provider Name | Victor Manuel Diaz-gonzalez |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1952303620 PECOS PAC ID: 7911047063 Enrollment ID: I20091221000439 |
| Provider Name | Steven A Meixel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821033085 PECOS PAC ID: 2668375106 Enrollment ID: I20100216000558 |
| Provider Name | Michele G Lively |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437116241 PECOS PAC ID: 6305973413 Enrollment ID: I20100421000838 |
| Provider Name | Bernard Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730164229 PECOS PAC ID: 7113058074 Enrollment ID: I20100622000346 |
| Provider Name | Rya Kaplan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1225070436 PECOS PAC ID: 2860495827 Enrollment ID: I20101015000801 |
| Provider Name | Angela M Mislowsky |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1770764318 PECOS PAC ID: 6103998240 Enrollment ID: I20110106000816 |
| Provider Name | Cynthia Neal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649287087 PECOS PAC ID: 9032390158 Enrollment ID: I20110223000301 |
| Provider Name | Carrie Deluca |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1093820235 PECOS PAC ID: 6507037926 Enrollment ID: I20110915000400 |
| Provider Name | Daniel Single |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1164489761 PECOS PAC ID: 9133032048 Enrollment ID: I20111103000435 |
| Provider Name | Eugene V Mayeaux |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780685966 PECOS PAC ID: 5890960439 Enrollment ID: I20111209000778 |
| Provider Name | Jackson Mccrea Ewart |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1699955005 PECOS PAC ID: 0345324554 Enrollment ID: I20111220000601 |
| Provider Name | Cynthia G Bindner |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1942273420 PECOS PAC ID: 9335311133 Enrollment ID: I20111222000320 |
| Provider Name | Kimberley A Drayton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386767226 PECOS PAC ID: 0446442347 Enrollment ID: I20111229000001 |
| Provider Name | Gayle Serafini Richmond |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1144292624 PECOS PAC ID: 8729992862 Enrollment ID: I20111229000789 |
| Provider Name | Lisa Maselli |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1346212834 PECOS PAC ID: 8426220229 Enrollment ID: I20111230000571 |
| Provider Name | Edgar Victor Archambeau |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659325124 PECOS PAC ID: 7911165964 Enrollment ID: I20120221001115 |
| Provider Name | Sonya D Harden |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1902104995 PECOS PAC ID: 7810155561 Enrollment ID: I20120227000263 |
| Provider Name | Thomas Scott Ellison |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1780630574 PECOS PAC ID: 9133229073 Enrollment ID: I20120424000250 |
| Provider Name | William J Greer |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1649288705 PECOS PAC ID: 9830193473 Enrollment ID: I20121107000052 |
| Provider Name | Vincent E Digiovanna |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1215114590 PECOS PAC ID: 7618164393 Enrollment ID: I20121212000024 |
| Provider Name | Anne Vierela |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1225312192 PECOS PAC ID: 3375786007 Enrollment ID: I20130828000880 |
| Provider Name | Stephanie J Hightower |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629261342 PECOS PAC ID: 3274617444 Enrollment ID: I20130830000777 |
| Provider Name | Kathleen Boone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538143391 PECOS PAC ID: 5597998617 Enrollment ID: I20140425000721 |
| Provider Name | Mikhail Vinogradov |
|---|---|
| Provider Type | Practitioner - Hematology |
| Provider Identifiers | NPI Number: 1073518452 PECOS PAC ID: 7911979497 Enrollment ID: I20140818002161 |
| Provider Name | Catherine Baker Burbage |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1639358310 PECOS PAC ID: 6507021730 Enrollment ID: I20140826002839 |
| Provider Name | Janis W Harvey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750367918 PECOS PAC ID: 7214197185 Enrollment ID: I20141008002474 |
| Provider Name | Sebastian Abadie |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1407875586 PECOS PAC ID: 2769480227 Enrollment ID: I20150818004672 |
| Provider Name | Carrie Suzanne Gwyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467837369 PECOS PAC ID: 1850608134 Enrollment ID: I20150918001121 |
| Provider Name | Ashley Marie Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154780732 PECOS PAC ID: 6800195843 Enrollment ID: I20160426001896 |
| Provider Name | Mark Leslie Witkowski |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1982998100 PECOS PAC ID: 0941451389 Enrollment ID: I20160628002190 |
| Provider Name | Justin Horwitz |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1528201670 PECOS PAC ID: 3274707476 Enrollment ID: I20161108001175 |
| Provider Name | Saint Julien Springs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063825230 PECOS PAC ID: 4981928207 Enrollment ID: I20161109002364 |
| Provider Name | Christopher Tran Bach |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1821313057 PECOS PAC ID: 4789834276 Enrollment ID: I20161116000013 |
| Provider Name | Melissa Baker Patterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235671140 PECOS PAC ID: 8426338120 Enrollment ID: I20161215001990 |
| Provider Name | Malcolm D Eggart |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1104142223 PECOS PAC ID: 6608146600 Enrollment ID: I20170725001091 |
| Provider Name | Andrew B Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265968770 PECOS PAC ID: 8123399482 Enrollment ID: I20170803003830 |
| Provider Name | Paul Westley Benson |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1487822730 PECOS PAC ID: 1456595958 Enrollment ID: I20170807000569 |
| Provider Name | Jesse Thomas Lewis |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1770889131 PECOS PAC ID: 1254633068 Enrollment ID: I20170809001544 |
| Provider Name | Amy J Bach |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598046971 PECOS PAC ID: 5799957510 Enrollment ID: I20170817002934 |
| Provider Name | Ryan J Galica |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1275891749 PECOS PAC ID: 3971879560 Enrollment ID: I20171026001531 |
| Provider Name | Jacob Hurlan Brazee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043630387 PECOS PAC ID: 2961760186 Enrollment ID: I20171218000958 |
| Provider Name | Michael Andrew Malone |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912980210 PECOS PAC ID: 6507926169 Enrollment ID: I20180312002503 |
| Provider Name | Jessica Morjain |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609296367 PECOS PAC ID: 5092077180 Enrollment ID: I20180330000724 |
| Provider Name | William Paul Didelot |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1932184058 PECOS PAC ID: 2062437387 Enrollment ID: I20180514000043 |
| Provider Name | Erica D Kouns |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053817411 PECOS PAC ID: 1759632557 Enrollment ID: I20180918001757 |
| Provider Name | Monica Lynn Selander-han |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1770997017 PECOS PAC ID: 9133449341 Enrollment ID: I20180926003720 |
| Provider Name | Sierra Fisher Ard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821571514 PECOS PAC ID: 4981949633 Enrollment ID: I20181227001135 |
| Provider Name | Rebecca Bowie Hash |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306250550 PECOS PAC ID: 0143543835 Enrollment ID: I20190109003540 |
| Provider Name | Earl James Han |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1043574882 PECOS PAC ID: 2163664277 Enrollment ID: I20190218000688 |
| Provider Name | Catherine Scofield Harper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588137814 PECOS PAC ID: 3274872395 Enrollment ID: I20190306002743 |
| Provider Name | Mark Andrew Rowley |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1922194257 PECOS PAC ID: 1951380997 Enrollment ID: I20190311001758 |
| Provider Name | Dayna Chinners Wilder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558831925 PECOS PAC ID: 3476893256 Enrollment ID: I20190313002148 |
| Provider Name | Stephanie Marie Gonshor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073085965 PECOS PAC ID: 0042550766 Enrollment ID: I20190315002260 |
| Provider Name | Melissa J Moore |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1144548884 PECOS PAC ID: 3072838390 Enrollment ID: I20190610000281 |
| Provider Name | Roxanne P Latimer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912980822 PECOS PAC ID: 3274520846 Enrollment ID: I20190614001910 |
| Provider Name | Lisa Rose Centilli |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033417522 PECOS PAC ID: 3870726482 Enrollment ID: I20190621002724 |
| Provider Name | Diego Alejandro Lim |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1699038505 PECOS PAC ID: 1951611516 Enrollment ID: I20190822003815 |
| Provider Name | Daniel J Staples |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1033771357 PECOS PAC ID: 2961733282 Enrollment ID: I20191016003754 |
| Provider Name | Vered Butbul Benezra |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528611605 PECOS PAC ID: 3779915988 Enrollment ID: I20191108001671 |
| Provider Name | Mark David Chanaca |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1346290939 PECOS PAC ID: 5799794582 Enrollment ID: I20191226000038 |
| Provider Name | Melissa Ann Gray |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1437109774 PECOS PAC ID: 7517391600 Enrollment ID: I20191226000129 |
| Provider Name | Mary Catherine Chrabaszcz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154724839 PECOS PAC ID: 5799008744 Enrollment ID: I20191226002114 |
| Provider Name | Michelle Alisse Henry |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1841362878 PECOS PAC ID: 4284068164 Enrollment ID: I20191231001357 |
| Provider Name | Michelle Ponsler Sine |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1841241098 PECOS PAC ID: 6305270299 Enrollment ID: I20191231001681 |
| Provider Name | Lauren Elizabeth Colbert |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1922656842 PECOS PAC ID: 1557795275 Enrollment ID: I20200106000013 |
| Provider Name | William J. Daley |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1295977668 PECOS PAC ID: 8729412473 Enrollment ID: I20200106000852 |
| Provider Name | Anita D Giardino |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1649342098 PECOS PAC ID: 1850725532 Enrollment ID: I20200106001990 |
| Provider Name | Kaitlyn Sierra Harper |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1750897864 PECOS PAC ID: 4789018482 Enrollment ID: I20200106002785 |
| Provider Name | Frank Moreno |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1831233774 PECOS PAC ID: 1658597976 Enrollment ID: I20200106003034 |
| Provider Name | James Frazer Kuykendall |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1619927217 PECOS PAC ID: 2567896129 Enrollment ID: I20200107002640 |
| Provider Name | Robert Alan Pendley |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1750370029 PECOS PAC ID: 2163487968 Enrollment ID: I20200324002315 |
| Provider Name | Daniel C Michalski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841830940 PECOS PAC ID: 2466882022 Enrollment ID: I20200422000764 |
| Provider Name | Anna C Catalano |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508392440 PECOS PAC ID: 3072882414 Enrollment ID: I20200619001883 |
| Provider Name | Vasudha Jain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982131603 PECOS PAC ID: 2264706456 Enrollment ID: I20200709002157 |
| Provider Name | Kegan Sherard Jessamy |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1770997991 PECOS PAC ID: 7618214222 Enrollment ID: I20200709003033 |
| Provider Name | Sean Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225568181 PECOS PAC ID: 0244504447 Enrollment ID: I20200710002403 |
| Provider Name | Michael B Remines |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205891942 PECOS PAC ID: 2860433950 Enrollment ID: I20200714003356 |
| Provider Name | Pia Anishka Shivdasani |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1376926147 PECOS PAC ID: 4789910894 Enrollment ID: I20200909001752 |
| Provider Name | Megan Patrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801419213 PECOS PAC ID: 9032537725 Enrollment ID: I20200911002042 |
| Provider Name | Gauri Dhir |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1407053879 PECOS PAC ID: 0042383523 Enrollment ID: I20200925002540 |
| Provider Name | Henry Lau |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861432601 PECOS PAC ID: 2264435551 Enrollment ID: I20201013003627 |
| Provider Name | Carol M Reid |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1508974361 PECOS PAC ID: 1355477399 Enrollment ID: I20201030000274 |
| Provider Name | Selena Augustine Chamberlain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720688807 PECOS PAC ID: 5799196242 Enrollment ID: I20201204001540 |
| Provider Name | Alyssa Rice |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1770957409 PECOS PAC ID: 7012218852 Enrollment ID: I20201208000616 |
| Provider Name | Andrea Richmond-mart |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1437508579 PECOS PAC ID: 9335429661 Enrollment ID: I20201214000625 |
| Provider Name | Suzanne Skinner |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1912960055 PECOS PAC ID: 5698786317 Enrollment ID: I20210120003104 |
| Provider Name | Deborah Ruth Mckee |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1992768907 PECOS PAC ID: 2062589435 Enrollment ID: I20210128000433 |
| Provider Name | Eileen Anne Egan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225290364 PECOS PAC ID: 9830253830 Enrollment ID: I20210215000206 |
| Provider Name | Jeffrey Cronk |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1811956220 PECOS PAC ID: 4981673266 Enrollment ID: I20210302001849 |
| Provider Name | Victoria Lynn Kiningham |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1164018057 PECOS PAC ID: 4183030364 Enrollment ID: I20210312002019 |
| Provider Name | Catherine Chatillon Bourne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164029104 PECOS PAC ID: 3274941612 Enrollment ID: I20210422003019 |
| Provider Name | Eileen Conaway |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023310281 PECOS PAC ID: 3577791425 Enrollment ID: I20210519000492 |
| Provider Name | Nitesh J. Ainani |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1952718074 PECOS PAC ID: 3476770470 Enrollment ID: I20210713001899 |
| Provider Name | Alexander Suda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417449695 PECOS PAC ID: 8921343609 Enrollment ID: I20210730002052 |
| Provider Name | Debra Mccauley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578094124 PECOS PAC ID: 5092087171 Enrollment ID: I20210804000456 |
| Provider Name | Jack Johnston |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1033590054 PECOS PAC ID: 1951601210 Enrollment ID: I20210804000609 |
| Provider Name | Vinh Doan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265927792 PECOS PAC ID: 2668717349 Enrollment ID: I20210804001868 |
| Provider Name | Christian Joseph Eccles |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1093100844 PECOS PAC ID: 9234426578 Enrollment ID: I20210812000348 |
| Provider Name | Oluwaseun A Omofoye |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1215296223 PECOS PAC ID: 6608096151 Enrollment ID: I20210819001564 |
| Provider Name | Adam Tanious |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1508108994 PECOS PAC ID: 9931459013 Enrollment ID: I20210831002310 |
| Provider Name | Matthew Joel Mccoskey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992293450 PECOS PAC ID: 1951707280 Enrollment ID: I20210910002050 |
| Provider Name | Jacqueline Sennott |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1629411707 PECOS PAC ID: 3173744018 Enrollment ID: I20210913000602 |
| Provider Name | Scott Callaghan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1497747018 PECOS PAC ID: 4385696582 Enrollment ID: I20210922000132 |
| Provider Name | Annacecilia Peacher Holderied |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1891053195 PECOS PAC ID: 6305180613 Enrollment ID: I20210923002012 |
| Provider Name | Matthew Edward Gibson |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1316386303 PECOS PAC ID: 3173745064 Enrollment ID: I20210924000179 |
| Provider Name | Sarah Carver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356913271 PECOS PAC ID: 8426447640 Enrollment ID: I20211109003529 |
| Provider Name | Hope Justine Brinkmann |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1447827068 PECOS PAC ID: 8022407790 Enrollment ID: I20211118000861 |
| Provider Name | Elizabeth Heather Kaplan |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1760053573 PECOS PAC ID: 2961892161 Enrollment ID: I20211202000582 |
| Provider Name | Jo Anne Klein |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1548465651 PECOS PAC ID: 8628129913 Enrollment ID: I20220125002674 |
| Provider Name | Mika Lynn Zeeryp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952067662 PECOS PAC ID: 7911390646 Enrollment ID: I20220202000047 |
| Provider Name | Allison Devaux |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326715343 PECOS PAC ID: 0446644074 Enrollment ID: I20220225000048 |
| Provider Name | Laura Young |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1497917231 PECOS PAC ID: 1153614839 Enrollment ID: I20220317002284 |
| Provider Name | Crystal Jean Connors |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629357272 PECOS PAC ID: 9638341779 Enrollment ID: I20220328001376 |
| Provider Name | Salem Zeglin |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1831792076 PECOS PAC ID: 6709272545 Enrollment ID: I20220405000856 |
| Provider Name | Bert Lawrence Fichman |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1508866716 PECOS PAC ID: 7618967415 Enrollment ID: I20220422000374 |
| Provider Name | Portia Toon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790446847 PECOS PAC ID: 0749668689 Enrollment ID: I20220603002492 |
| Provider Name | Melissa Erin Wyche |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1316438294 PECOS PAC ID: 3779833728 Enrollment ID: I20220810003916 |
| Provider Name | Michael Alvarado |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1750801841 PECOS PAC ID: 4385915610 Enrollment ID: I20220825003765 |
| Provider Name | Kirsten Van Demark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508507161 PECOS PAC ID: 6507241825 Enrollment ID: I20220922000210 |
| Provider Name | Elizabeth Colonna |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1831154269 PECOS PAC ID: 9234108291 Enrollment ID: I20220928002190 |
| Provider Name | Olga Chrisman |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1881120764 PECOS PAC ID: 9133499643 Enrollment ID: I20221014003038 |
| Provider Name | Taylor Thrash |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871158121 PECOS PAC ID: 7012349053 Enrollment ID: I20221110000148 |
| Provider Name | Melissa Vogt |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1063902294 PECOS PAC ID: 0345590394 Enrollment ID: I20221110003234 |
| Provider Name | Jillian Melissa Siniscalchi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023744919 PECOS PAC ID: 0749657336 Enrollment ID: I20221111000358 |
| Provider Name | Thomas Hamilton Plyler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710608963 PECOS PAC ID: 4981073806 Enrollment ID: I20221214003075 |
| Provider Name | Abby Sapp |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1538400247 PECOS PAC ID: 5294023057 Enrollment ID: I20221228000695 |
| Provider Name | Andrew Nguyen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1881258218 PECOS PAC ID: 1951635564 Enrollment ID: I20221230002501 |
| Provider Name | Elizabeth A Suniega |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902206907 PECOS PAC ID: 5193043362 Enrollment ID: I20230109002300 |
| Provider Name | Dana Zanone |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578507968 PECOS PAC ID: 7315912938 Enrollment ID: I20230124000335 |
| Provider Name | Charmaine Eulette Belto-mills |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124685573 PECOS PAC ID: 9931571825 Enrollment ID: I20230201002834 |
| Provider Name | Theresa Lynn Paquette |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1124767082 PECOS PAC ID: 8820460322 Enrollment ID: I20230209001912 |
| Provider Name | Cynthia Riley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093429508 PECOS PAC ID: 9234502501 Enrollment ID: I20230307002737 |
| Provider Name | Taylor Harrison Polk |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093343584 PECOS PAC ID: 4082074083 Enrollment ID: I20230724000624 |
| Provider Name | Elizabeth Dixon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386267037 PECOS PAC ID: 3577986983 Enrollment ID: I20230726001354 |
| Provider Name | Daniel Cunningham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427308980 PECOS PAC ID: 9537478698 Enrollment ID: I20230726001750 |
| Provider Name | Julia Marie Hulsey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811490907 PECOS PAC ID: 6901273309 Enrollment ID: I20230726004198 |
| Provider Name | Micah Raven Bennett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275211823 PECOS PAC ID: 5799146833 Enrollment ID: I20230804002102 |
| Provider Name | Susan Berger |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1518416379 PECOS PAC ID: 4981972767 Enrollment ID: I20230825002528 |
| Provider Name | Amy Reed |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1285602805 PECOS PAC ID: 8628064201 Enrollment ID: I20230906004342 |
| Provider Name | Sara B Shields Tarwater |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1447786926 PECOS PAC ID: 9436526555 Enrollment ID: I20230915000618 |
| Provider Name | Ming Yin |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1255630505 PECOS PAC ID: 4981976297 Enrollment ID: I20230922003542 |
| Provider Name | Adam Christian |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255956561 PECOS PAC ID: 1850759150 Enrollment ID: I20231016003308 |
| Provider Name | Beth Charlette |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1124752548 PECOS PAC ID: 9234585860 Enrollment ID: I20231102000371 |
| Provider Name | Angela Doyle |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1164157699 PECOS PAC ID: 3274900592 Enrollment ID: I20231108000699 |
| Provider Name | Jorge Peacher |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1629052253 PECOS PAC ID: 9830368406 Enrollment ID: I20231115001299 |
| Provider Name | Kimberly Kight Johansen |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1104890698 PECOS PAC ID: 2769422864 Enrollment ID: I20231206001586 |
| Provider Name | Mark Okonski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952393209 PECOS PAC ID: 5092751800 Enrollment ID: I20240130000185 |
| Provider Name | Heather Partridge |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013354612 PECOS PAC ID: 8123463833 Enrollment ID: I20240304001202 |
| Provider Name | Franklin Clemons, Jr. |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669432878 PECOS PAC ID: 3971972209 Enrollment ID: I20240415003845 |
| Provider Name | Annie Miller Elvington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609638279 PECOS PAC ID: 2961842612 Enrollment ID: I20240429003442 |
| Provider Name | Kyle Allan Forman |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1912760463 PECOS PAC ID: 9638519002 Enrollment ID: I20240502000449 |
Strand Regional Specialty Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4367 Riverwood Dr, Suite 120, Murrells Inlet, SC 29576 Phone: 843-357-8008 Fax: 843-357-3819 | |
Roper St. Francis After Hours Care - Murrells Inlet Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 912 Inlet Square Dr, Suite A, Murrells Inlet, SC 29576 Phone: 843-651-4111 Fax: 843-651-1047 | |
Diabetes Center Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 11891 Plaza Drive, Murrells Inlet, SC 29576 Phone: 843-353-0288 Fax: 843-357-9770 | |
Coastal House Calls, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 671 Jamestown Dr, Suite 203, Murrells Inlet, SC 29576 Phone: 843-631-4656 | |
Palmetto Primary Care Physicians, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 912 Inlet Square Dr, Murrells Inlet, SC 29576 Phone: 843-651-4111 | |
T J Reardon Md Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 671 Jamestown Dr, Ste 202a, Murrells Inlet, SC 29576 Phone: 864-237-1184 |