NPIMap

Organization Active NPI

Inmed Diagnostics Services of SC LLC

  • Radiology Clinic/Center
  • Myrtle Beach, SC
National Provider Identifier
1184740680
Registry record updated Oct 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
License
85342 Issued in SC
Legal business name
INMED DIAGNOSTICS SERVICES OF SC LLC
Practice address
4701 Oleander Dr
Ste C
Myrtle Beach, SC 29577-5762
Phone
(843) 692-0040
Fax
(843) 692-0046
NPI assigned
Mar 22, 2007
Last updated
Oct 31, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2014

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

Authorized official

Name
Elizabeth Longton
Title
Ceo
Phone
(954) 510-3704

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X 85342 SC Primary

Addresses

Primary practice location

4701 Oleander Dr
Ste C
Myrtle Beach, SC 29577-5762

Mailing address

2400 E Commercial Blvd
Suite 826
Ft Lauderdale, FL 33308-4054
Phone (954) 510-3700

Other identifiers 1

IdentifierTypeStateIssuer
PL0068MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141025000053 SC Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 7315901972 Practice locations: Myrtle Beach, SC

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Inmed Diagnostic Services of SC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414713600000",
    "number": "1184740680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 E COMMERCIAL BLVD",
            "address_2": "SUITE 826",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084054",
            "telephone_number": "954-510-3700",
            "fax_number": "954-510-2649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 OLEANDER DR",
            "address_2": "STE C",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295775762",
            "telephone_number": "843-692-0040",
            "fax_number": "843-692-0046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INMED DIAGNOSTICS SERVICES OF SC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2014-10-31",
        "status": "A",
        "authorized_official_last_name": "LONGTON",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "954-510-3704"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "SC",
            "license": "85342",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PL0068",
            "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 Oct 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.