Individual provider Active NPI

George B Nicholson Jr., MD

  • Surgery Physician
  • Myrtle Beach, SC
National Provider Identifier
1184608937
Registry record updated Mar 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
9938 Issued in SC
Practice address
845 82ND Pkwy
Myrtle Beach, SC 29572-4614
Phone
(843) 449-9621
Fax
(843) 449-4921
NPI assigned
Dec 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 9938 SC Primary

Addresses

Primary practice location

845 82ND Pkwy
Myrtle Beach, SC 29572-4614

Mailing address

845 82ND Pkwy
Myrtle Beach, SC 29572-4614
Phone (843) 449-9621

Other identifiers 1

IdentifierTypeStateIssuer
099388MedicaidSC

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100726000691 SC Practitioner - General Surgery 6901939008 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Medical University of South Carolina College of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Surgical Associates of Myrtle Beach, LLCGroup PAC ID 4587552179, 2 clinicians

Practice addresses (Care Compare)

210 Village Ctr Blvd
Suite 110
Myrtle Beach, SC 29579-6706
Phone (843) 449-9621

Hospital & facility affiliations

  • Grand Strand Regional Medical Center Hospital, Myrtle Beach, SC, CCN 420085
  • McLeod Loris Hospital Hospital, Loris, SC, CCN 420105

Merit-based Incentive Payment System (MIPS)

Final score
86.2 of 100Reported as individual
Quality
85.84
Improvement activities
40
Cost
72.86

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Mastectomy47

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Surgical Associates of Myrtle Beach, LLC Surgery CurrentSince Jan 1, 1995 Accepting new patients

Locations

210 Village Center Blvd
Ste 110
Myrtle Beach, SC 29579
Phone (843) 449-8079

845 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 449-9621

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ADBCDD
  • FHIR API: https://fhir4.healow.com/fhir/r4/ADBCDD/Endpoint/ADBCDD

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269216000000",
    "number": "1184608937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 82ND PKWY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724614",
            "telephone_number": "843-449-9621",
            "fax_number": "843-449-4921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 82ND PKWY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724614",
            "telephone_number": "843-449-9621",
            "fax_number": "843-449-4921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "GEORGE",
        "middle_name": "B",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-05",
        "last_updated": "2010-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "9938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "099388",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.