Michael Kouandjio, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

39234 Issued in OK

Practice address

Grand Strand Medical Center-Gme Office
809 82ND Parkway
Myrtle Beach, SC 29572

Phone

(843) 848-4640

Fax

(843) 839-2382

NPI assigned

Mar 26, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Services of Oklahoma PCGroup PAC ID 8123209012, 63 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Integris Community Hospital - Council Crossing Hospital, Oklahoma City, OK, CCN 370240

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michael.kouandjio@hca5.eclinicaldirectplus.com

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.

• Emergency Services of Oklahoma PC

  • Emergency Medicine Physician
  • Norman, OK
  • NPI 1215249891
  Medicare reassignment Care Compare group NPD
• Emergency Physicians of Mid-America, P.C.

  • Emergency Medicine Physician
  • Oklahoma City, OK
  • NPI 1063825297
  Medicare reassignment NPD
• South Central Emergency Services PC

  • Emergency Medicine Physician
  • Stillwater, OK
  • NPI 1558663724
  Medicare reassignment NPD
• Iacc/Ehi NW, LLC

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1194209155
  NPD (past)
• Iacc/Ehi NW, LLC

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1336623198
  NPD (past)
• Iacc/Ehi NW, LLC

  • General Acute Care Hospital
  • Moore, OK
  • NPI 1447734272
  NPD (past)
• Iacc/Ehi NW, LLC

  • General Acute Care Hospital
  • Del City, OK
  • NPI 1942784715
  NPD (past)

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

• Iacc/Ehi NW, LLC

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1194209155
  Care Compare affiliation
• Iacc/Ehi NW, LLC

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1336623198
  Care Compare affiliation
• Iacc/Ehi NW, LLC

  • General Acute Care Hospital
  • Moore, OK
  • NPI 1447734272
  Care Compare affiliation
• Iacc/Ehi NW, LLC

  • General Acute Care Hospital
  • Del City, OK
  • NPI 1942784715
  Care Compare affiliation

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

{
    "created_epoch": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1154882975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "GRAND STRAND MEDICAL CENTER-GME OFFICE",
            "address_2": "809 82ND PARKWAY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "29572",
            "telephone_number": "843-848-4640",
            "fax_number": "843-839-2382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GRAND STRAND MEDICAL CENTER-GME OFFICE",
            "address_2": "809 82ND PARKWAY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "29572",
            "telephone_number": "843-848-4640",
            "fax_number": "843-839-2382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUANDJIO",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-26",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "39234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jimmy L Kontos, MD
• Teresa Regina Kontos, MD
• Jarrett Koper, DO
• Hope Koroly, PT, DPT
• William Henry Korthals III, MSW, LCSW
• Roger N Kourey, DMD08
• Amanda L Koury, PHARMD
• Stephen Francis Kovacs III, LISW-CP
• Seth Addison Kozlowski, DO, PA-C
• Bernard Charles Krafsig II, MD

• Emergency Medicine Physician in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Emergency Medicine Physician in South Carolina

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

Verify at the official NPI Registry.