Myrtle Beach Dermatology

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

19296 Issued in SC

Legal business name

MYRTLE BEACH DERMATOLOGY

Practice address

1275 21St Ave N BLDG 2
Myrtle Beach, SC 29577-7514

Phone

(843) 449-9140

Fax

(843) 497-5110

NPI assigned

May 9, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Richard Henry Hussey III, M.D.NPI 1558365346

Title

Partner

Phone

(843) 449-9410

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 2

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

• Richard Henry Hussey III, M.D.

  • Dermatology Physician
  • Myrtle Beach, SC
  • NPI 1558365346

  Dermatology, SC

  Medicare reassignment NPD Authorized official
• Robert Scott Purvis, MD

  • Dermatology Physician
  • Myrtle Beach, SC
  • NPI 1154373827

  Dermatology

  NPD (past)

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724112000000",
    "number": "1285683003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 21ST AVE N BLDG 2",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295777514",
            "telephone_number": "843-449-9140",
            "fax_number": "843-497-5110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 21ST AVE N BLDG 2",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295777514",
            "telephone_number": "843-449-9140",
            "fax_number": "843-497-5110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYRTLE BEACH DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A",
        "authorized_official_last_name": "HUSSEY",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "HENRY",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "843-449-9410",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "SC",
            "license": "19296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Myrtle Beach, SC
• Dermatology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.