Individual provider Active NPI

Robin H Starr, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Myrtle Beach, SC
National Provider Identifier
1053384537
Registry record updated Feb 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
19708 Issued in SC
Practice address
603 Chestnut Rd
Myrtle Beach, SC 29572-5503
Phone
(843) 945-1452
Fax
(843) 945-1489
NPI assigned
Feb 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 0050-01561 NC
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 19708 SC Primary

Addresses

Primary practice location

603 Chestnut Rd
Myrtle Beach, SC 29572-5503

Mailing address

603 Chestnut Rd
Myrtle Beach, SC 29572-5503
Phone (843) 945-1452

Other identifiers 2

IdentifierTypeStateIssuer
19708OtherSCSTATE LICENSE
100504506MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160722000517 SC Practitioner - Nurse Practitioner 8527959006 Reassigns benefits to 1 organization
Practice locations: Conway, SC; Myrtle Beach, SC

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
19708SCMDVascular & Interventional Radiology Physician
0050-01561NCMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Robin H Starr Psychiatric/Mental Health CurrentSince Jan 25, 2018 Accepting new patients
Wound Therapy Professionals, Inc PastSince May 1, 2003 Accepting new patients
Nash Street Healthcare Past Accepting new patients
Advanced Practice Mental Health and Wellness of South Carolina L.L.C. Psychiatric/Mental Health PastSince Jun 18, 2023 Accepting new patients
Sovran Senior Living, LLC Past Accepting new patients
Essential Geriatric Care, PA PastSince May 24, 2020 Accepting new patients

Locations

630 Chestnut Rd
Unit 14
Myrtle Beach, SC 29572
Phone (843) 274-8070

630 Chestnut Rd
Ste 14
Myrtle Beach, SC 29572
Phone (843) 945-1452

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517616000000",
    "number": "1053384537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 CHESTNUT RD",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295725503",
            "telephone_number": "843-945-1452",
            "fax_number": "843-945-1489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 CHESTNUT RD",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295725503",
            "telephone_number": "843-945-1452",
            "fax_number": "843-945-1489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARR",
        "first_name": "ROBIN",
        "middle_name": "H",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-07",
        "last_updated": "2018-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NC",
            "license": "0050-01561",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "SC",
            "license": "19708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "19708",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100504506",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.