NPIMap

Organization Active NPI

Myrtle Beach Anesthesia Associates, LLC

  • Certified Registered Nurse Anesthetist
  • Myrtle Beach, SC
National Provider Identifier
1033924568
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
MYRTLE BEACH ANESTHESIA ASSOCIATES, LLC
Practice address
7900 N Kings Hwy Ste B
Myrtle Beach, SC 29572-3055
Phone
(843) 839-2581
NPI assigned
Feb 11, 2025
Last updated
Jul 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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

Authorized official

Name
Jeff Perry
Title
RCM Manager
Phone
(502) 418-4700

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

7900 N Kings Hwy Ste B
Myrtle Beach, SC 29572-3055

Mailing address

PO Box 736336
Dallas, TX 75373-6336
Phone (888) 717-5383

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250423001366 SC Part B Supplier - Clinic/Group Practice 4385169226 Receives reassigned benefits from 15 practitioners
Practice locations: Myrtle Beach, SC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1739232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753228800000",
    "number": "1033924568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 736336",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753736336",
            "telephone_number": "888-717-5383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 N KINGS HWY STE B",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295723055",
            "telephone_number": "843-839-2581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYRTLE BEACH ANESTHESIA ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-11",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "RCM MANAGER",
        "authorized_official_telephone_number": "502-418-4700"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "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 Jul 23, 2025; 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.