NPIMap

Organization Active NPI

Grand Strand Dermatology

  • Dermatology Physician
  • Myrtle Beach, SC
National Provider Identifier
1033160213
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
17893 Issued in SC
Legal business name
GRAND STRAND DERMATOLOGY
Practice address
7410 Highway 707
Myrtle Beach, SC 29588-7304
Phone
(843) 215-1100
Fax
(843) 215-1211
NPI assigned
May 13, 2006
Last updated
Oct 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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

Authorized official

Name
Nathan Patrick JonesNPI 1528245560
Title
Managing Partner
Phone
(843) 215-1100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 17893 SC Primary

Addresses

Primary practice location

7410 Highway 707
Myrtle Beach, SC 29588-7304

Mailing address

7410 Highway 707
Myrtle Beach, SC 29588-7304
Phone (843) 215-1100

Other practice location 1

933 Medical Cir
Myrtle Beach, SC 29572-4116
Phone (843) 215-1100

Other identifiers 2

IdentifierTypeStateIssuer
GP0495MedicaidSC
178952MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041008000261 SC Part B Supplier - Clinic/Group Practice 8921067596 Receives reassigned benefits from 10 practitioners
Practice locations: Murrells Inlet, SC; Myrtle Beach, SC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D2181692Grand Strand Dermatology933 Medical Circle, Myrtle Beach, SC 29572ComplianceJul 31, 2026
42D2282632Grand Strand Dermatology7410 Highway 707, Myrtle Beach, SC 29588ComplianceSep 29, 2027

National Provider Directory

National Provider Directory

Locations

3001 Newcastle Loop
Myrtle Beach, SC 29588
Phone (843) 215-1100

4573 Oleander Dr
Myrtle Beach, SC 29577
Phone (843) 449-9140

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761782400000",
    "number": "1033160213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7410 HIGHWAY 707",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295887304",
            "telephone_number": "843-215-1100",
            "fax_number": "843-215-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7410 HIGHWAY 707",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295887304",
            "telephone_number": "843-215-1100",
            "fax_number": "843-215-1211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "933 Medical Cir",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295724116",
            "country_code": "US",
            "telephone_number": "843-215-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GRAND STRAND DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-13",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "843-215-1100"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "SC",
            "license": "17893",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP0495",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "178952",
            "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 Oct 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.