Active NPI
Jiajia O'Shea, D.O.
- Emergency Medicine Physician
- Myrtle Beach, SC
National Provider Identifier
1235424136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- DO37602
- Practice address
- 55 Bayberry LN
Myrtle Beach, SC 29572-5600 - Phone
- (978) 621-2457
- NPI assigned
- Jun 20, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | OT01397 | PA | |
| Emergency Medicine Physician | 207P00000X | DO37602 | SC | Primary |
Addresses
Primary practice location
55 Bayberry LN
Myrtle Beach, SC 29572-5600
Mailing address
55 Bayberry LN
Myrtle Beach, SC 29572-5600
Phone (978) 621-2457
Other names 1
- Dr. Jiajia Gao
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150520002702 | SC | Practitioner - Emergency Medicine | 6709106420 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- University of New England, College of Osteo Medicine, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Conway Hospital Emergency Professional ServicesAcs Primary Care Physicians - Southeast PC
Practice addresses (Care Compare)
300 Singleton Ridge Rd
Conway, SC 29526-9142
Phone (843) 347-7111
809 82ND Pkwy
Myrtle Beach, SC 29572-4607
Phone (843) 692-1000
Hospital & facility affiliations
- Conway Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO37602 | SC | MD | Emergency Medicine Physician |
| OT01397 | PA | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Conway Hospital Emergency Professional Services | Emergency Medicine | Current | Accepting new patients |
| Acs Primary Care Physicians - Southeast PC | Emergency Medicine | Current | Accepting new patients |
Locations
300 Singleton Ridge Rd
Conway, SC 29526
Phone (843) 234-6946
4000 Highway 9 E
Little River, SC 29566
Phone (843) 390-8100
3655 Mitchell St
Loris, SC 29569
Phone (843) 716-7000
809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182
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.
-
- Emergency Medicine Physician
- Myrtle Beach, SC
- NPI 1861430555
Emergency Medicine, SC
-
- Emergency Medicine Physician
- Conway, SC
- NPI 1487844510
Emergency Medicine, SC
Hospital & facility affiliations 13
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": "1308528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474502400000",
"number": "1235424136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 BAYBERRY LN",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295725600",
"telephone_number": "978-621-2457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 BAYBERRY LN",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295725600",
"telephone_number": "978-621-2457"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'SHEA",
"first_name": "JIAJIA",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-20",
"last_updated": "2016-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "PA",
"license": "OT01397",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "SC",
"license": "DO37602",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JIAJIA",
"last_name": "GAO",
"prefix": "DR.",
"credential": "DO",
"code": "1",
"type": "Former Name"
}
]
}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 Sep 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.