Organization Active NPI

Carolina Regional Surgery Center. LTD

  • Ambulatory Surgical Clinic/Center
  • Myrtle Beach, SC
National Provider Identifier
1275596264
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
ASF069 Issued in SC
Legal business name
CAROLINA REGIONAL SURGERY CENTER. LTD
Practice address
1021 Medical Cir
Suite 100
Myrtle Beach, SC 29572-4618
Phone
(843) 449-7885
Fax
(843) 497-5137
NPI assigned
Apr 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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

Authorized official

Name
David McKnight
Title
VP/Cfo
Phone
(972) 789-2816

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X ASF069 SC Primary

Addresses

Primary practice location

1021 Medical Cir
Suite 100
Myrtle Beach, SC 29572-4618

Mailing address

1021 Medical Cir Ste 100
Myrtle Beach, SC 29572-4618
Phone (843) 449-7885

Other identifiers 1

IdentifierTypeStateIssuer
410148MedicaidSC

Other names 1

  • Grande Dunes Surgery Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080108000559 SC Part B Supplier - Ambulatory Surgical Center 4880774413 Practice locations: Myrtle Beach, SC

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Carolina Regional Surgery Center LTDCCN 42C0001014
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D1019187Grande Dunes Surgery Center1021 Medical Circle Suite 100, Myrtle Beach, SC 29572Certificate of waiverNov 11, 2027

National Provider Directory

National Provider Directory

Locations

1021 Cipriana Dr
Ste 100
Myrtle Beach, SC 29572
Phone (843) 449-7885

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788912000000",
    "number": "1275596264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 MEDICAL CIR STE 100",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724618",
            "telephone_number": "843-449-7885",
            "fax_number": "843-497-5137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 MEDICAL CIR",
            "address_2": "SUITE 100",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724618",
            "telephone_number": "843-449-7885",
            "fax_number": "843-497-5137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA REGIONAL SURGERY CENTER. LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-10",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A",
        "authorized_official_last_name": "MCKNIGHT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "VP/CFO",
        "authorized_official_telephone_number": "972-789-2816"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "SC",
            "license": "ASF069",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "410148",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grande Dunes Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.