Active NPI
Meredith Bugenske
- Pediatric Physical Therapist
- Myrtle Beach, SC
National Provider Identifier
1295066751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 6132
- Practice address
- 4201 Carolina Exchange Dr
Suite 102
Myrtle Beach, SC 29579-4221 - Phone
- (843) 455-7505
- NPI assigned
- Jan 23, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 6132 | SC | Primary |
Addresses
Primary practice location
4201 Carolina Exchange Dr
Suite 102
Myrtle Beach, SC 29579-4221
Mailing address
4201 Carolina Exchange Dr
Suite 102
Myrtle Beach, SC 29579-4221
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6132 | SC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1264204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264204800000",
"number": "1295066751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4201 CAROLINA EXCHANGE DR",
"address_2": "SUITE 102",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295794221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4201 CAROLINA EXCHANGE DR",
"address_2": "SUITE 102",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295794221",
"telephone_number": "843-455-7505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUGENSKE",
"first_name": "MEREDITH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-01-23",
"last_updated": "2010-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "SC",
"license": "6132",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Jan 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.