Tidelands GHS Joint Venture LLC
A Medicare group practice based in Myrtle Beach, SC: 2 NPIs enrolled under one PECOS associate control ID (PAC ID 6800030578), with 3 clinicians.
Medicare enrollment
Medicare enrollment files- PAC ID
- 6800030578
- Provider type
- Part A Provider - Hospice, Part B Supplier - Clinic/Group Practice
- Enrolled in
- SC
- Enrollments
- 2
- Group size
- 2 clinicians
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Practice locations
- 5
Enrollment records 2
| Enrollment ID | State | Provider type | NPI |
|---|---|---|---|
| O20130919000020 | SC | Part A Provider - Hospice | 1154303089 |
| O20240201004536 | SC | Part B Supplier - Clinic/Group Practice | 1669878559 |
NPIs in this group 2
NPPES NPI RegistryThese NPI records belong to the same enrolled organization. Each has its own page.
-
Tidelands GHS Joint Venture LLC
dba Tidelands Community Hospice
- Community Based Hospice Care Agency
- Georgetown, SC
- NPI 1154303089
-
Tidelands GHS Joint Venture LLC
dba Tidelands Community Palliative Care
- Hospice and Palliative Medicine (Family Medicine) Physician
- Georgetown, SC
- NPI 1669878559
Practice locations
- Myrtle Beach, SC3
- Georgetown, SC2
Clinicians 3
Clinicians who reassign their Medicare benefits to this group (3) or whom Care Compare lists as members (2).
-
Amanda Copeland, NP
- Gerontology Nurse Practitioner
- Myrtle Beach, SC
- NPI 1417490640
-
Shana J Mackin, NP-C
- Acute Care Nurse Practitioner
- Georgetown, SC
- NPI 1538755301
-
Angela Carter Sheridan, FNP
- Family Nurse Practitioner
- Georgetown, SC
- NPI 1043460215
Sources for this page
- Medicare Fee-For-Service Public Provider Enrollment: the enrollments, PAC ID, practice locations and benefit reassignments.
- Care Compare Doctors and Clinicians: group membership, group size and the name CMS shows patients.
- NPPES NPI Registry: the names and addresses of the NPIs above.