Individual provider Active NPI

Rebecca Diane Cody, MD

  • Hematology & Oncology Physician
  • Myrtle Beach, SC
National Provider Identifier
1265425763
Registry record updated Jun 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
22443 Issued in SC
Practice address
8121 Rourk St
Myrtle Beach, SC 29572-4128
Phone
(843) 692-5000
Fax
(843) 692-5015
NPI assigned
Aug 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 22443 SC Primary
Hematology & Oncology Physician 207RH0003X 200100855 NC

Addresses

Primary practice location

8121 Rourk St
Myrtle Beach, SC 29572-4128

Mailing address

8121 Rourk St
Myrtle Beach, SC 29572-4128
Phone (843) 692-5000

Other identifiers 2

IdentifierTypeStateIssuer
89064HWMedicaidNC
T67291MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181112002238 MS Practitioner - Medical OncologyPractitioner - Internal Medicine 1759373962 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Medical OncologyAlso: Internal Medicine
Education
University of Mississippi School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Mississippi Medical Center, Inc.Group PAC ID 9931010600, 361 clinicians

Practice addresses (Care Compare)

961 S Gloster St
North Mississippi Medical Center Hematology
Tupelo, MS 38801-6343
Phone (662) 377-4550

Hospital & facility affiliations

  • North Mississippi Medical Center Hospital, Tupelo, MS, CCN 250004
  • North Mississippi Medical Center-Gilmore Amory Hospital, Amory, MS, CCN 250025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
200100855NCMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Medcial Center, Inc. CurrentSince Aug 1, 2023 Accepting new patients
Thompson Oncology Group Hematology & Oncology CurrentSince Dec 23, 2018 Accepting new patients
North Mississippi Medical Center Inc Current Accepting new patients
North Mississippi Medical Center, Inc Hematology & Oncology CurrentSince Aug 1, 2023 Accepting new patients
Coastal Cancer Center LLC Hematology & Oncology CurrentSince Jul 14, 2012 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Amory Surgery Clinic, PLLC Past Accepting new patients

Locations

808 Varsity Dr
Tupelo, MS 38801
Phone (662) 377-2386

961 S Gloster St
Tupelo, MS 38801
Phone (601) 844-9166

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

7 Medical Center Dr
Supply, NC 28462
Phone (910) 755-7509

8121 Rourk St
Myrtle Beach, SC 29572
Phone (843) 692-5000

1915 White Ave
Knoxville, TN 37916
Phone (423) 977-1065

Dept 888078
Knoxville, TN 37995

908 W 4th North St
Morristown, TN 37814
Phone (423) 492-9000

Organizations & group practices 7

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.

Hospital & facility affiliations 2

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": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339632000000",
    "number": "1265425763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8121 ROURK ST",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724128",
            "telephone_number": "843-692-5000",
            "fax_number": "843-692-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8121 ROURK ST",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724128",
            "telephone_number": "843-692-5000",
            "fax_number": "843-692-5015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CODY",
        "first_name": "REBECCA",
        "middle_name": "DIANE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-30",
        "last_updated": "2012-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "SC",
            "license": "22443",
            "primary": true
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NC",
            "license": "200100855",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89064HW",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T67291",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.