NPIMap

Organization Active NPI

Inlet Physical Medicine LLC

  • Interventional Pain Medicine Physician
  • Murrells Inlet, SC
National Provider Identifier
1255603403
Registry record updated Sep 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
30634 Issued in SC
Legal business name
INLET PHYSICAL MEDICINE LLC
Practice address
804 Inlet Square Dr Unit B
Murrells Inlet, SC 29576-7874
Phone
(843) 652-5678
Fax
(843) 652-5679
NPI assigned
Feb 3, 2012
Last updated
Sep 23, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2013

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

Authorized official

Name
Mr. Craig Steven CohenNPI 1659406759
Title
Owner
Phone
(843) 652-5678

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X 30634 SC
Interventional Pain Medicine Physician 208VP0014X 30634 SC Primary

Addresses

Primary practice location

804 Inlet Square Dr Unit B
Murrells Inlet, SC 29576-7874

Mailing address

804 Inlet Square Dr Unit B
Murrells Inlet, SC 29576-7874
Phone (843) 652-5678

Other identifiers 1

IdentifierTypeStateIssuer
A843OtherSCMEDICARE PTAN

National Provider Directory

National Provider Directory

Locations

804 Inlet Square Dr
Unit B
Murrells Inlt, SC 29576
Phone (843) 357-8222

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1328227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379894400000",
    "number": "1255603403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 INLET SQUARE DR UNIT B",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295767874",
            "telephone_number": "843-652-5678",
            "fax_number": "843-652-5679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 INLET SQUARE DR UNIT B",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295767874",
            "telephone_number": "843-652-5678",
            "fax_number": "843-652-5679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INLET PHYSICAL MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-03",
        "last_updated": "2013-09-23",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-652-5678",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "SC",
            "license": "30634",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "SC",
            "license": "30634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "A843",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrells Inlet, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.