Individual provider Active NPI

Amy Jean Bloch, MD

  • Emergency Medicine Physician
  • Myrtle Beach, SC
National Provider Identifier
1275709024
Registry record updated Oct 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
33456 Issued in SC
Practice address
809 82ND Pkwy
Myrtle Beach, SC 29572-4607
Phone
(843) 497-5929
Fax
(843) 497-6601
NPI assigned
May 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 061210 GA
Emergency Medicine Physician 207P00000X 33456 SC Primary

Addresses

Primary practice location

809 82ND Pkwy
Myrtle Beach, SC 29572-4607

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842

Other practice location 1

14 Richland Medical Park Dr Ste 350
Columbia, SC 29203-6896
Phone (803) 434-1663

Other identifiers 1

IdentifierTypeStateIssuer
G61210MedicaidSC

Other names 1

  • Amy Jean Craig Former name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110525000516 SC Practitioner - Emergency Medicine 5092888248 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
061210GAMDEmergency Medicine Physician
33456SCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands Emergency Medicine CurrentSince Sep 1, 2021 Accepting new patients
Prisma Health-Midlands Current Accepting new patients
Prisma Health-Midlands Emergency Medicine CurrentSince Sep 24, 2014 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Sep 1, 2021 Accepting new patients

Locations

14 Richland Medical Park Dr
Ste 350
Columbia, SC 29203
Phone (803) 434-1663

1330 Taylor St
Ste 100
Columbia, SC 29201
Phone (803) 434-6410

400 Palmetto Health Pkwy
Columbia, SC 29212
Phone (803) 296-5579

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

Interoperability endpoints

  • Direct secure messaging: abloch412412@direct.ghs.myhfn.org

Organizations & group practices 4

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": "1209600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1275709024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 82ND PKWY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724607",
            "telephone_number": "843-497-5929",
            "fax_number": "843-497-6601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14 Richland Medical Park Dr Ste 350",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292036896",
            "country_code": "US",
            "telephone_number": "803-434-1663",
            "fax_number": "803-434-3984",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLOCH",
        "first_name": "AMY",
        "middle_name": "JEAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-01",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "061210",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "33456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G61210",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "CRAIG",
            "middle_name": "JEAN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.