Carolina Forest Imaging Center LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

CAROLINA FOREST IMAGING CENTER LLC

Practice address

199 Village Center Blvd
Suite 110
Myrtle Beach, SC 29579

Phone

(843) 236-7878

Fax

(843) 236-6406

NPI assigned

Aug 8, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Lavelle R Hardin

Title

Credentialing Coordinator

Phone

(615) 344-8203

Specialties & licenses 3

Addresses

Other identifiers 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Billie Ed Shelley Jr., MD

  • Diagnostic Radiology Physician
  • Conway, SC
  • NPI 1205812252
  NPD (past)
• William L Woodard, MD

  • Diagnostic Radiology Physician
  • Charleston, SC
  • NPI 1710963624
  NPD (past)

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

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196380800000",
    "number": "1063603587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 VILLAGE CENTER BLVD",
            "address_2": "SUITE 110",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "29579",
            "telephone_number": "843-236-7878",
            "fax_number": "843-236-6406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 VILLAGE CENTER BLVD",
            "address_2": "SUITE 110",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "29579",
            "telephone_number": "843-236-7878",
            "fax_number": "843-236-6406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA FOREST IMAGING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-08",
        "last_updated": "2007-11-30",
        "status": "A",
        "authorized_official_last_name": "HARDIN",
        "authorized_official_first_name": "LAVELLE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "615-344-8203",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0206X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mammography",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4758",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carolina Forest Chiropractic, LLC
• Carolina Forest Family Eyecare, P.a.
• Carolina Forest Family Medicine
• Carolina Forest Hearing Center of SC LLC
• Carolina Forest Hearing Center, P.C.
• Carolina Forest Imaging Center LLC
• Carolina Forest Urgent Care LLC
• Carolina Health and Recovery
• Carolina Health Pharmacy LLC
• Carolina Orthopaedic Specialists

• Radiology Clinic/Center in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Radiology Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2007; 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.