NPIMap

Individual provider Active NPI

Dalal A Akoury, M.D.

  • Emergency Medicine Physician
  • Myrtle Beach, SC
National Provider Identifier
1154350965
Registry record updated Apr 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0101046726 Issued in VA
Practice address
4710 Oleander Drive
Myrtle Beach, SC 29577-5898
Phone
(843) 213-1480
Fax
(843) 712-1973
NPI assigned
Jul 2, 2006
Last updated
Apr 18, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0101046726 VA Primary
Family Medicine Physician 207Q00000X 9800006 NC
Pediatrics Physician 208000000X 9800006 NC

Addresses

Primary practice location

4710 Oleander Drive
Myrtle Beach, SC 29577-5898

Mailing address

4710 Oleander Drive
Myrtle Beach, SC 29577-5898
Phone (843) 213-1480

Other identifiers 6

IdentifierTypeStateIssuer
3069481MedicaidTN
3069481MedicaidVA
010256135MedicaidVA
P00387371OtherTNRAILROAD MEDICARE
010289661MedicaidVA
3136318OtherTNBLUE CROSS BLUE SHEILD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9800006NCMDSchool Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeway Emergency Physicians, LLC Emergency Medicine Past Accepting new patients
Emergency Coverage Services, PC Past Accepting new patients
United Emergency Services, Inc. Emergency Medicine Past Accepting new patients
Awaremed Wholistic Urgent Care PLLC Past Accepting new patients
Emergency Coverage, LLC Emergency Medicine Past Accepting new patients
Bladen County Emergency Physicians PLLC Emergency Medicine Past Accepting new patients
Rutherford Emergency Medicine PA Emergency Medicine Past Accepting new patients
Upstate Emergency Service Emergency Medicine Past Accepting new patients
Spartanburg Emergency Physicians, LLC Emergency Medicine Past Accepting new patients
E Jackson St Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Franklin Regional Emergency Physicians PLLC Emergency Medicine Past Accepting new patients

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334707200000",
    "number": "1154350965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4710 OLEANDER DRIVE",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295775898",
            "telephone_number": "843-213-1480",
            "fax_number": "843-712-1973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4710 OLEANDER DRIVE",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295775898",
            "telephone_number": "843-213-1480",
            "fax_number": "843-712-1973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AKOURY",
        "first_name": "DALAL",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-02",
        "last_updated": "2012-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101046726",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "9800006",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "9800006",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3069481",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3069481",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010256135",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00387371",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010289661",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "3136318",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Apr 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.