Carleen Willeford, DNP
Individual provider Active NPI Family Nurse Practitioner · North Myrtle Beach, SC
NPI 1164641908 · NPPES record last updated Nov 6, 2025
Key facts
- NPI
- 1164641908
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- APN3204RX (SC)
- Practice address
- 416 Main St
North Myrtle Beach, SC 29582-3024 - Phone
- (843) 663-0933
- Fax
- (843) 663-0936
- NPI assigned
- Apr 24, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Grace Family Services Inc
Practice addresses (Care Compare)
2406 Madison Dr
North Myrtle Beach, SC 29582-4334
Phone (843) 663-0748
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240926001814 | SC | Practitioner - Nurse Practitioner | 6103879309 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201524 | NC | MD | Family Nurse Practitioner |
| 3024 | SC | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grace Family Services Inc | Multi-Specialty | Current |
Accepting new patients |
| Sandhills Intergrated Care, Inc. | Multi-Specialty | Current |
Accepting new patients |
| Coastal Carolinas Integrated Medicine PA | Multi-Specialty | Past |
Accepting new patients |
Locations
2406 Madison Dr
North Myrtle Beach, SC 29582
Phone (843) 663-0748
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APN3204RX | SC | Yes |
| Family Nurse Practitioner | 363LF0000X | 201524 | NC | |
| Psychiatric/Mental Health Nurse Practitioner |
363LP0808X | 3024 | SC |
Addresses
Primary practice location
416 Main St
North Myrtle Beach, SC 29582-3024
Mailing address
10 Doctors Cir
Suite 2
Supply, NC 28462-4089
Phone (910) 755-6060
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 016UX | Other | NC | BCBS NC PROVIDER NUMBER |
| 8987642 | Medicaid | NC |
Other providers in North Myrtle Beach, SC
- David Mark Weitzman
- Amy Michele Wendelowski
- Teresa Werner
- Aaron Brent Westerlund
- Elma Denise Whidby
- Brielle Lynn Williams
- Grace O Williams
- Shannon Marie Willoughby
- Donald Jared Wilson
- Alisha Carter Witmore
All providers in North Myrtle Beach, SC · Family Nurse Practitioner in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 6, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.