Individual provider Active NPI

Lauren Kuperus, NP-C

  • Family Nurse Practitioner
  • Myrtle Beach, SC
National Provider Identifier
1164973855
Registry record updated Nov 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
19898 Issued in SC
Practice address
3411 Socastee Blvd
Myrtle Beach, SC 29588-6111
Phone
(866) 389-2727
NPI assigned
Oct 18, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 19898 SC Primary

Addresses

Primary practice location

3411 Socastee Blvd
Myrtle Beach, SC 29588-6111

Mailing address

2169 Eastwoods Dr
Conway, SC 29526-7714
Phone (843) 855-4673

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170112002334 SC Practitioner - Nurse Practitioner 4880976505 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic Diagnostic South Carolina LLCGroup PAC ID 8527126861, 113 clinicians

Practice addresses (Care Compare)

2996 E Hwy 501
Conway, SC 29526-9532
Phone (866) 389-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic South Carolina LLC Family CurrentSince Oct 24, 2016 Accepting new patients
Minuteclinic Primary Care South Carolina LLC Family CurrentSince Sep 17, 2025 Accepting new patients

Locations

2996 E Highway 501
Conway, SC 29526
Phone (843) 347-2613

3411 Socastee Blvd
Myrtle Beach, SC 29588
Phone (843) 294-1285

8995 University Blvd
North Charleston, SC 29406
Phone (843) 410-0701

698 Fairview Rd
Simpsonville, SC 29680
Phone (864) 962-8991

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.

NPI Registry JSON

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

{
    "created_epoch": "1476748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573603200000",
    "number": "1164973855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2169 EASTWOODS DR",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295267714",
            "telephone_number": "843-855-4673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3411 SOCASTEE BLVD",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295886111",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUPERUS",
        "first_name": "LAUREN",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-18",
        "last_updated": "2019-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "19898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.