NPIMap

Organization Active NPI

SC Pain & Spine Specialists, LLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Murrells Inlet, SC
National Provider Identifier
1003197328
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
24751 Issued in SC
Legal business name
SC PAIN & SPINE SPECIALISTS, LLC
Practice address
4731 Highway 17
Murrells Inlet, SC 29576-5090
Phone
(843) 839-7246
Fax
(843) 839-7323
NPI assigned
Aug 31, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Polly Price
Title
Billing Administrator
Phone
(843) 669-5162

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2081P2900X 24751 SC Primary

Addresses

Primary practice location

4731 Highway 17
Murrells Inlet, SC 29576-5090

Mailing address

PO Box 100523
Florence, SC 29502-0523
Phone (843) 669-5162

Other identifiers 1

IdentifierTypeStateIssuer
GP5802MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110929000776 SC Part B Supplier - Clinic/Group Practice 4587836275 Receives reassigned benefits from 10 practitioners
1 other NPI on this enrollment
Practice locations: Georgetown, SC; Little River, SC; Murrells Inlet, SC; Myrtle Beach, SC; Conway, SC

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

822 Farrar Dr
Conway, SC 29526
Phone (843) 347-9587

230 S Fraser St
Georgetown, SC 29440
Phone (843) 461-4735

1569 Highway 17
Little River, SC 29566

4112 Carolina Commercial Dr
Myrtle Beach, SC 29579

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1314748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709596800000",
    "number": "1003197328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100523",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295020523",
            "telephone_number": "843-669-5162",
            "fax_number": "843-667-4573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4731 HIGHWAY 17",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295765090",
            "telephone_number": "843-839-7246",
            "fax_number": "843-839-7323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SC PAIN & SPINE SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-31",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A",
        "authorized_official_last_name": "PRICE",
        "authorized_official_first_name": "POLLY",
        "authorized_official_title_or_position": "BILLING ADMINISTRATOR",
        "authorized_official_telephone_number": "843-669-5162",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "SC",
            "license": "24751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP5802",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrells Inlet, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.