Individual provider Active NPI

Casey Charles Jones, NP

  • Family Nurse Practitioner
  • Myrtle Beach, SC
National Provider Identifier
1205631819
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
30704 Issued in SC
Practice address
920 Doug White Dr Ste 210
Myrtle Beach, SC 29572-4181
Phone
(843) 497-6348
Fax
(843) 497-6351
NPI assigned
Feb 17, 2025
Last updated
Nov 20, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 30704 SC Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

920 Doug White Dr Ste 210
Myrtle Beach, SC 29572-4181

Mailing address

920 Doug White Dr Ste 210
Myrtle Beach, SC 29572-4181
Phone (843) 497-6348

Other practice location 1

1601 Greene St
Columbia, SC 29208-4001
Phone (803) 777-7412

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
I20251210001017 SC Practitioner - Nurse Practitioner 1658865407 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grand Strand Surgical Specialists LLCGroup PAC ID 4082770656, 57 clinicians

Practice addresses (Care Compare)

920 Doug White Dr
Suite 210
Myrtle Beach, SC 29572-4181
Phone (843) 497-6348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
30704SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Strand Surgical Specialists, LLC CurrentSince Dec 14, 2025 Accepting new patients
Coastal Carolina Multispecialty Associates, LLC PastSince Nov 24, 2025 Accepting new patients

Locations

4237 River Hills Dr
Ste 150
Little River, SC 29566
Phone (843) 281-2778

920 Doug White Dr
Ste 210
Myrtle Beach, SC 29572
Phone (843) 497-6348

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1739750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1205631819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 DOUG WHITE DR STE 210",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724181",
            "telephone_number": "843-497-6348",
            "fax_number": "843-497-6351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 DOUG WHITE DR STE 210",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724181",
            "telephone_number": "843-497-6348",
            "fax_number": "843-497-6351"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 Greene St",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292084001",
            "country_code": "US",
            "telephone_number": "803-777-7412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "CASEY",
        "middle_name": "CHARLES",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-17",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "30704",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.