NPIMap

Organization Active NPI

Conway Hospital, Inc.

Doing business as CMC Neurology

  • Neurology Physician
  • Conway, SC
National Provider Identifier
1104223908
Registry record updated Feb 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
CONWAY HOSPITAL, INC.
Doing business as
CMC Neurology
Practice address
8024 Myrtle Trace Dr
Conway, SC 29526-8945
Phone
(843) 234-8950
Fax
(843) 234-8951
NPI assigned
Nov 24, 2014
Last updated
Feb 15, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2022

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

Authorized official

Name
Mary Ellen Artioli
Title
Credentialing Specialist
Phone
(843) 234-6946

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X NU
Neurology Physician 2084N0400X SC
Neurology Physician 2084N0400X NU Primary

Addresses

Primary practice location

8024 Myrtle Trace Dr
Conway, SC 29526-8945

Mailing address

300 Singleton Ridge Rd
Attn: Patient Accounting
Conway, SC 29526-9142
Phone (843) 234-6946

Other identifiers 1

IdentifierTypeStateIssuer
GP7301MedicaidSC

Other names 3

  • CMC NEUROLOGY Doing business as
  • CONWAY HOSPITAL COMMUNITY SERVICES Former legal business name
  • CPG NEUROLOGY Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031201000111 SC Part B Supplier - Clinic/Group Practice 7113839606 Receives reassigned benefits from 148 practitioners
41 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Conway, SC; Surfside Beach, SC; Myrtle Beach, SC; Murrells Inlet, SC; Little River, SC; Florence, SC

Other NPIs on the same Medicare enrollment 40

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 40

National Provider Directory

National Provider Directory
Tax ID family
Conway Hospital Inc40 organizations share this tax ID, including this one

Other organizations with this tax ID 39

Organizations that report the same tax identification number in the National Provider Directory.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1416787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644883200000",
    "number": "1104223908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SINGLETON RIDGE RD",
            "address_2": "ATTN: PATIENT ACCOUNTING",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295269142",
            "telephone_number": "843-234-6946",
            "fax_number": "843-234-6990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8024 MYRTLE TRACE DR",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295268945",
            "telephone_number": "843-234-8950",
            "fax_number": "843-234-8951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONWAY HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-24",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A",
        "authorized_official_last_name": "ARTIOLI",
        "authorized_official_first_name": "MARY ELLEN",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "843-234-6946"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP7301",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CMC NEUROLOGY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CONWAY HOSPITAL COMMUNITY SERVICES",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "CPG NEUROLOGY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Conway, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2022; 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.