Active NPI
Wilma J Spencer, NP
- Nurse Practitioner
- Myrtle Beach, SC
National Provider Identifier
1003035965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- R78330
- Practice address
- 7724 N Kings Hwy
Myrtle Beach, SC 29572-3041 - Phone
- (843) 663-1013
- Fax
- (843) 663-1017
- NPI assigned
- Apr 25, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | R78330 | SC | Primary |
Addresses
Primary practice location
7724 N Kings Hwy
Myrtle Beach, SC 29572-3041
Mailing address
PO Box 547
Little River, SC 29566-0547
Phone (843) 663-1013
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 57-0672117 | Other | SC | TAX ID # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R78330 | SC | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296086400000",
"number": "1003035965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 547",
"city": "LITTLE RIVER",
"state": "SC",
"postal_code": "295660547",
"telephone_number": "843-663-1013",
"fax_number": "843-663-1017"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7724 N KINGS HWY",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295723041",
"telephone_number": "843-663-1013",
"fax_number": "843-663-1017"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPENCER",
"first_name": "WILMA",
"middle_name": "J",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-25",
"last_updated": "2011-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "SC",
"license": "R78330",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID #",
"identifier": "57-0672117",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Myrtle Beach, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.