Individual provider Active NPI

Janelle Morgan, PA

  • Physician Assistant
  • Myrtle Beach, SC
National Provider Identifier
1235530569
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
210 Village Center Blvd
Suite 200
Myrtle Beach, SC 29579-6706
Phone
(843) 236-3222
Fax
(843) 236-3005
NPI assigned
Sep 5, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2205 SC
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

210 Village Center Blvd
Suite 200
Myrtle Beach, SC 29579-6706

Mailing address

210 Village Center Blvd
Suite 200
Myrtle Beach, SC 29579-6706
Phone (843) 236-3222

Other identifiers 1

IdentifierTypeStateIssuer
2205OtherSCMEDICAL LICENSE

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
I20141201001349 SC Practitioner - Physician Assistant 8527380666 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2205SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Medicos, P.a. PastSince Feb 11, 2024 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1409875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1235530569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 VILLAGE CENTER BLVD",
            "address_2": "SUITE 200",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295796706",
            "telephone_number": "843-236-3222",
            "fax_number": "843-236-3005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 VILLAGE CENTER BLVD",
            "address_2": "SUITE 200",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295796706",
            "telephone_number": "843-236-3222",
            "fax_number": "843-236-3005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORGAN",
        "first_name": "JANELLE",
        "name_prefix": "Miss",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-05",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "2205",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "2205",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.