Active NPI
Misty Danelle Polston Whipkey, NP
- Dermatology Physician
- Myrtle Beach, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 21023
- Practice address
- 917 Medical Cir
Myrtle Beach, SC 29572-4116 - Phone
- (843) 449-0453
- NPI assigned
- May 30, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 21023 | SC | |
| Dermatology Physician | 207N00000X | 21023 | SC | Primary |
Addresses
Primary practice location
917 Medical Cir
Myrtle Beach, SC 29572-4116
Mailing address
917 Medical Cir
Myrtle Beach, SC 29572-4116
Phone (843) 449-0453
Other names 1
- Misty Danelle Polston
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
917 Medical Cir
Myrtle Beach, SC 29572-4116
Phone (843) 449-0453
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.01 of 100
- Quality
- 100
- Improvement activities
- 40
- Cost
- 66.69
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Waccamaw Dermatology, LLC | Dermatology | Current | Accepting new patients |
| Coastal Kidney Center PA | Past | Accepting new patients |
Locations
2725 Iron Gate Dr
Ste 100
Wilmington, NC 28412
834 Farrar Dr
Conway, SC 29526
Phone (843) 347-9487
166 Waccamaw Medical Park Ct
Conway, SC 29526
Phone (843) 449-8079
705 N 8th Ave
Ste 3B
Dillon, SC 29536
Phone (843) 841-3825
505 Belle Hall Pkwy
Unit 202
Mt Pleasant, SC 29464
5046 Highway 17 Byp S
Ste 200
Myrtle Beach, SC 29588
Phone (843) 839-3501
8170 Rourk St
Ste 100
Myrtle Beach, SC 29572
Phone (843) 282-1915
8170 Rourk St
Ste 175
Myrtle Beach, SC 29572
917 Medical Cir
Myrtle Beach, SC 29572
5046 Highway 17 Byp S
Ste 203
Myrtle Beach, SC 29588
Phone 8432941941310
14880 Ocean Hwy
Pawleys Island, SC 29585
Phone (843) 237-1569
5500 Front St
Ste 260
Summerville, SC 29486
Interoperability endpoints
- mpolston@directaddress.net
Organizations & group practices 2
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.
-
- Dermatology Physician
- Myrtle Beach, SC
- NPI 1962449181
-
- Nephrology Physician
- Conway, SC
- NPI 1801961537
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711411200000",
"number": "1124556584",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "917 MEDICAL CIR",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295724116",
"telephone_number": "843-449-0453"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "917 MEDICAL CIR",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295724116",
"telephone_number": "843-449-0453"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLSTON WHIPKEY",
"first_name": "MISTY",
"middle_name": "DANELLE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-30",
"last_updated": "2024-03-26",
"certification_date": "2024-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "SC",
"license": "21023",
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "SC",
"license": "21023",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MISTY",
"last_name": "POLSTON",
"middle_name": "DANELLE",
"credential": "NP",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Myrtle Beach, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.