NPIMap

Individual provider Active NPI

Nicholas Koroneos, MS, DO

  • Neurology Physician
  • Little River, SC
National Provider Identifier
1134622913
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
90056 Issued in SC
Practice address
3980 Highway 9 E Ste 300
Little River, SC 29566-8165
Phone
(843) 646-8040
Fax
(843) 646-8049
NPI assigned
Mar 17, 2018
Last updated
Aug 8, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 90056 SC Primary

Addresses

Primary practice location

3980 Highway 9 E Ste 300
Little River, SC 29566-8165

Mailing address

123 Stethem Dr
Centereach, NY 11720-4083
Phone (929) 813-2742

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
I20230922001538 SC Practitioner - Neurology 9436503513 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
New York College of Osteo Medicine of New York Institute of Technology, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

101 McLeod Health Blvd
Suite 201
Myrtle Beach, SC 29579-4477
Phone (843) 646-8001

107 McLeod Health Blvd
Myrtle Beach, SC 29579-4477

3980 Hwy 9 E
Little River, SC 29566-8165

555 E Cheves St
Florence, SC 29506-2617
Phone (843) 777-2000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy30

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Master of Science

State licenses

LicenseStateTypeSpecialty
90056SCMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Regional Medical Center of the Pee Dee, Inc Neurology CurrentSince Sep 15, 2024 Accepting new patients
McLeod Physician Associates II Neurology CurrentSince Oct 1, 2023 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc CurrentSince Sep 15, 2024 Accepting new patients
McLeod Physician Associates II CurrentSince Oct 1, 2023 Accepting new patients

Locations

555 E Cheves St
Florence, SC 29506
Phone (843) 662-5233

800 E Cheves St
Ste 240
Florence, SC 29506
Phone (843) 777-7950

800 E Cheves St
Ste 480A
Florence, SC 29506
Phone (843) 777-7337

3980 Highway 9 E
Ste 300
Little River, SC 29566
Phone (843) 366-3891

3655 Mitchell St
Loris, SC 29569
Phone (843) 716-7000

Interoperability endpoints

  • Direct secure messaging: nkoroneos85507@directmcleodehealth.org

Organizations & group practices 4

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 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1521244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1134622913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 STETHEM DR",
            "city": "CENTEREACH",
            "state": "NY",
            "postal_code": "117204083",
            "telephone_number": "929-813-2742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3980 HIGHWAY 9 E STE 300",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295668165",
            "telephone_number": "843-646-8040",
            "fax_number": "843-646-8049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORONEOS",
        "first_name": "NICHOLAS",
        "credential": "MS, DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-17",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "SC",
            "license": "90056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little River, SC

Sources for this page

Verify at the official NPI Registry.