NPIMap

Individual provider Active NPI

Peggy Bourguillon, M.D.

  • Family Medicine Physician
  • Murrells Inlet, SC
National Provider Identifier
1073922753
Registry record updated Oct 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
51994 Issued in SC
Practice address
4959 Hwy 17 Bypass S.
Murrells Inlet, SC 29576
Phone
(843) 357-1299
Fax
(843) 357-2264
NPI assigned
Aug 7, 2014
Last updated
Oct 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 51994 SC Primary

Addresses

Primary practice location

4959 Hwy 17 Bypass S.
Murrells Inlet, SC 29576

Mailing address

PO Box 2474
Murrells Inlet, SC 29576-2474
Phone (843) 357-1299

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180523002308 SC Practitioner - Family Practice 3971807157 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
New York Medical College, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ochsner 65 Plus HH Okatie CrossingGroup PAC ID 5294181939, 6 clinicians

Practice addresses (Care Compare)

50 Terrace Dr
Ridgeland, SC 29936-5097
Phone (843) 547-4765

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Little River Medical Center, Inc. Family Medicine CurrentSince Mar 5, 2018 Accepting new patients
Little River Medical Center, Inc CurrentSince Mar 5, 2018 Accepting new patients
Ochsner 65 Plus HH Okatie Crossing CurrentSince Jul 29, 2024 Accepting new patients
Little River Medical Center, Inc. Family Medicine CurrentSince Mar 5, 2018 Accepting new patients
Little River Medical Center, Inc. Family Medicine CurrentSince Mar 5, 2018 Accepting new patients
Little River Medical Center Inc Family Medicine CurrentSince Mar 5, 2018 Accepting new patients

Locations

4303 Live Oak Dr
Little River, SC 29566
Phone (803) 839-3939

3817 Main St
Loris, SC 29569
Phone (843) 806-2601

3515 Caduceus Dr
Ste B
Myrtle Beach, SC 29588
Phone (843) 651-5689

4220 Carolina Exchange Dr
Myrtle Beach, SC 29579
Phone (843) 663-8013

7724 N Kings Hwy
Myrtle Beach, SC 29572
Phone (843) 839-3939

50 Terrace Dr
Ridgeland, SC 29936
Phone (843) 547-4765

Interoperability endpoints

  • Direct secure messaging: pbourguillon2288709@direct.ochsner.org
  • Direct secure messaging: peggy.bourguillon@hca5.eclinicaldirectplus.com

Organizations & group practices 7

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

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1407369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1073922753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2474",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295762474",
            "telephone_number": "843-357-1299",
            "fax_number": "843-357-2264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4959 HWY 17 BYPASS S.",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "29576",
            "telephone_number": "843-357-1299",
            "fax_number": "843-357-2264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURGUILLON",
        "first_name": "PEGGY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-07",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "51994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrells Inlet, SC

Sources for this page

Verify at the official NPI Registry.