Surgical Associates of Myrtle Beach, LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

SURGICAL ASSOCIATES OF MYRTLE BEACH, LLC

Practice address

845 82ND Pkwy
Myrtle Beach, SC 29572-4614

Phone

(843) 449-9621

Fax

(843) 449-4921

NPI assigned

Jun 4, 2006

Last updated

Nov 10, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lane Ingram MooreNPI 1598723900

Title

Partner

Phone

(843) 449-9621

Specialties & licenses 1

Addresses

Other names 1

• Surgical Associates of Myrtle Beach Other name

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/ADBCDD

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lane Ingram Moore, M.D.

  • Surgery Physician
  • Myrtle Beach, SC
  • NPI 1598723900
  Medicare reassignment Care Compare group NPD Authorized official
• George B Nicholson Jr., MD

  • Surgery Physician
  • Myrtle Beach, SC
  • NPI 1184608937
  Medicare reassignment Care Compare group NPD
• Lewis Garrett Dickinson, MD

  • Surgery Physician
  • Rock Hill, SC
  • NPI 1891779641
  NPD

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668038400000",
    "number": "1295773695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 82ND PKWY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724614",
            "telephone_number": "843-449-9621",
            "fax_number": "843-449-4921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 82ND PKWY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724614",
            "telephone_number": "843-449-9621",
            "fax_number": "843-449-4921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL ASSOCIATES OF MYRTLE BEACH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "LANE",
        "authorized_official_middle_name": "INGRAM",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "843-449-9621"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Surgical Associates of Myrtle Beach",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Surgical Associates of Myrtle Beach",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Surgery Physician in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Surgery Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; 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.