NPIMap

Organization Active NPI

Atlantic Urology Clinic LLC

  • Non-Pharmacy Dispensing Site
  • Little River, SC
National Provider Identifier
1043965775
Registry record updated Feb 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
ATLANTIC UROLOGY CLINIC LLC
Practice address
3600 Sea Mountain Hwy Ste B
Little River, SC 29566-8161
Phone
(843) 347-2450
NPI assigned
Feb 22, 2022
Organization subpart
Yes
Parent organization
ATLANTIC UROLOGY CLINIC.LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 22, 2022

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

Authorized official

Name
Debbie L Bolig
Title
Director of Revenue Cycle
Phone
(843) 347-2450

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X Primary

Addresses

Primary practice location

3600 Sea Mountain Hwy Ste B
Little River, SC 29566-8161

Mailing address

611 Burroughs and Chapin Blvd Ste 105
Myrtle Beach, SC 29577-3200
Phone (843) 222-9581

Other names 1

  • IOD-APUC Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL tgajewski@auc.emadirect.md Health Information Exchange (HIE)

National Provider Directory

National Provider Directory
Tax ID family
Atlantic Urology Clinic5 organizations share this tax ID, including this one
Part of
Atlantic Urology Clinic

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

611 Burroughs and Chapin Blvd
Ste 105
Myrtle Beach, SC 29577

NPI Registry JSON

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

{
    "created_epoch": "1645488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645488000000",
    "number": "1043965775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 BURROUGHS AND CHAPIN BLVD STE 105",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295773200",
            "telephone_number": "843-222-9581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 SEA MOUNTAIN HWY STE B",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295668161",
            "telephone_number": "843-347-2450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC UROLOGY CLINIC LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ATLANTIC UROLOGY CLINIC.LLC",
        "enumeration_date": "2022-02-22",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A",
        "authorized_official_last_name": "BOLIG",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE",
        "authorized_official_telephone_number": "843-347-2450"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "tgajewski@auc.emadirect.md",
            "affiliation": "N",
            "endpointDescription": "direct mail",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3600 Sea Mountain Hwy Ste B",
            "city": "Little River",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295668161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "IOD-APUC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Little River, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2022; 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.