NPIMap

Tidelands and Medquest Joint Venture, LLC

Organization Active NPI Radiology Clinic/Center · Myrtle Beach, SC

NPI 1083275366 · NPPES record last updated Apr 16, 2026

Key facts

NPI
1083275366
Entity type
Organization (NPI type 2)
Primary specialty
Radiology Clinic/Center 261QR0200X
Legal business name
TIDELANDS AND MEDQUEST JOINT VENTURE, LLC
Practice address
900 21St Ave N
Myrtle Beach, SC 29577-7483
Phone
(843) 916-1700
Fax
(843) 916-9460
NPI assigned
Jun 26, 2019
Organization subpart
No

Authorized official

Name
Erin Beadle
Title
Evp&Cfo
Phone
(843) 520-8617

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners 102

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

View all 102

Medicare participation

Medicare fee-for-service enrollment
Enrolled in SC

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20191127000540 SC Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 4587097894 Practice locations: Myrtle Beach, SC

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X Yes

Addresses

Primary practice location

900 21St Ave N
Myrtle Beach, SC 29577-7483

Mailing address

PO Box 421718
Georgetown, SC 29442-4203
Phone (843) 527-7000

Other names

  • Tidelands Health Imaging Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 16, 2026.

{
    "created_epoch": "1561507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776297600000",
    "number": "1083275366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421718",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294424203",
            "telephone_number": "843-527-7000",
            "fax_number": "843-916-9460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 21ST AVE N",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295777483",
            "telephone_number": "843-916-1700",
            "fax_number": "843-916-9460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDELANDS AND MEDQUEST JOINT VENTURE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-26",
        "last_updated": "2026-04-16",
        "certification_date": "2026-04-16",
        "status": "A",
        "authorized_official_last_name": "BEADLE",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "EVP&CFO",
        "authorized_official_telephone_number": "843-520-8617"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tidelands Health Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Myrtle Beach, SC

All providers in Myrtle Beach, SC · Radiology Clinic/Center in South Carolina

Sources for this page

Verify at the official NPI Registry.