Organization Active NPI

Nirvana Plastic Surgery, P.a.

  • Plastic Surgery Physician
  • Myrtle Beach, SC
National Provider Identifier
1023245966
Registry record updated Jan 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
31460 Issued in SC
Legal business name
NIRVANA PLASTIC SURGERY, P.A.
Practice address
8208A Devon CT
Myrtle Beach, SC 29572-4178
Phone
(843) 839-2004
Fax
(843) 839-2011
NPI assigned
Jun 18, 2009
Last updated
Jan 18, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2017

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

Authorized official

Name
Dr. Stephen David Duffy, M.D.
Title
President
Phone
(843) 839-2004

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 31460 SC Primary

Addresses

Primary practice location

8208A Devon CT
Myrtle Beach, SC 29572-4178

Mailing address

8208A Devon CT
Myrtle Beach, SC 29572-4178
Phone (843) 839-2004

National Provider Directory

National Provider Directory

Locations

1331 44th Ave N
Ste 101
Myrtle Beach, SC 29577
Phone (646) 528-8202

8208A Devon Ct
Myrtle Beach, SC 29572
Phone (843) 839-2004

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484697600000",
    "number": "1023245966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8208A DEVON CT",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724178",
            "telephone_number": "843-839-2004",
            "fax_number": "843-839-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8208A DEVON CT",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724178",
            "telephone_number": "843-839-2004",
            "fax_number": "843-839-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIRVANA PLASTIC SURGERY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-18",
        "last_updated": "2017-01-18",
        "status": "A",
        "authorized_official_last_name": "DUFFY",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-839-2004",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "SC",
            "license": "31460",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.