Organization Active NPI

States of Wellbeing

  • Family Medicine Physician
  • Myrtle Beach, SC
National Provider Identifier
1053285643
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
STATES OF WELLBEING
Practice address
176 Village Center Blvd
Myrtle Beach, SC 29579-5622
Phone
(304) 482-4826
Fax
(843) 484-3831
NPI assigned
Oct 6, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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

Authorized official

Name
Lindsey States, FNPNPI 1457668386
Title
Owner
Phone
(843) 633-2266

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

176 Village Center Blvd
Myrtle Beach, SC 29579-5622

Mailing address

810 Carolina Farms Blvd
Myrtle Beach, SC 29579-3568
Phone (843) 633-2266

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251216002326 SC Part B Supplier - Clinic/Group Practice 6507350683 Receives reassigned benefits from 1 practitioner
Practice locations: Myrtle Beach, SC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1759708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763424000000",
    "number": "1053285643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 CAROLINA FARMS BLVD",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295793568",
            "telephone_number": "843-633-2266",
            "fax_number": "843-484-3831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 VILLAGE CENTER BLVD",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295795622",
            "telephone_number": "304-482-4826",
            "fax_number": "843-484-3831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATES OF WELLBEING",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-06",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A",
        "authorized_official_last_name": "STATES",
        "authorized_official_first_name": "LINDSEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-633-2266",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "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 Nov 18, 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.