Active NPI
James O Merritt, MD
- Gynecology Physician
- Myrtle Beach, SC
National Provider Identifier
1174519011
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- 6403
- Practice address
- 911 Medical Cir
Myrtle Beach, SC 29572-4116 - Phone
- (843) 449-5553
- Fax
- (843) 449-4453
- NPI assigned
- Sep 26, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | 6403 | SC | Primary |
Addresses
Primary practice location
911 Medical Cir
Myrtle Beach, SC 29572-4116
Mailing address
4728 Jenn Dr
Suite 105
Myrtle Beach, SC 29577-5714
Phone (843) 449-5553
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 064030 | Medicaid | SC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6403 | SC | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grand Strand Gynecology | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Specialist
- Myrtle Beach, SC
- NPI 1578623039
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281571200000",
"number": "1174519011",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4728 JENN DR",
"address_2": "SUITE 105",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295775714",
"telephone_number": "843-449-5553",
"fax_number": "843-449-4453"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "911 MEDICAL CIR",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295724116",
"telephone_number": "843-449-5553",
"fax_number": "843-449-4453"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERRITT",
"first_name": "JAMES",
"middle_name": "O",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-26",
"last_updated": "2010-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "SC",
"license": "6403",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "064030",
"state": "SC"
}
],
"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 Aug 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.