NPIMap

Individual provider Active NPI

Farayi Jonnes Mbuvah, MD

  • Pain Medicine (Anesthesiology) Physician
  • Myrtle Beach, SC
National Provider Identifier
1306198841
Registry record updated Apr 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
81715 Issued in SC
Practice address
811 82ND Parkway Ste B
Myrtle Beach, SC 29572-4653
Phone
(843) 839-4598
Fax
(843) 839-4599
NPI assigned
Oct 8, 2012
Last updated
Apr 22, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 81715 SC Primary

Addresses

Primary practice location

811 82ND Parkway Ste B
Myrtle Beach, SC 29572-4653

Mailing address

300 Singleton Ridge Rd
Attention Patient Accounting
Conway, SC 29526-9142
Phone (843) 234-6946

Other practice location 1

8212 Devon Ct
Myrtle Beach, SC 29572-4178
Phone (417) 888-0167

Other identifiers 1

IdentifierTypeStateIssuer
817156MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190620003555 SC Practitioner - Pain Management 1951528322 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pain Management
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Conway Hospital IncGroup PAC ID 7113839606, 127 clinicians

Practice addresses (Care Compare)

300 Singleton Ridge Rd
Conway, SC 29526-9142
Phone (843) 347-7112

394 Singleton Ridge Rd
Conway, SC 29526-9150
Phone (843) 347-8050

6010 Hwy 707
Myrtle Beach, SC 29588-7321

8004 Myrtle Trace Dr
Conway, SC 29526-8945
Phone (843) 234-8939

8024 Myrtle Trace Dr
Conway, SC 29526-8945
Phone (843) 234-8950

811 82ND Pkwy
Suite B
Myrtle Beach, SC 29572-4653
Phone (843) 839-4598

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
52.78 of 100Reported as group
Quality
55.48
Improvement activities
0
Cost
74.21

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion11

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Conway Hospital, Inc. CurrentSince Jun 1, 2022 Accepting new patients
Conway Hospital, Inc. Current Accepting new patients
Elite Pain Management, LLC CurrentSince May 1, 2019 Accepting new patients
Elite Pain Management, LLC CurrentSince May 1, 2019 Accepting new patients
Atlantic Coast Anesthesia Services P.C. CurrentSince May 27, 2020 Accepting new patients
Conway Hospital, Inc. Internal Medicine Past Accepting new patients

Locations

222 E Primrose St
Ste E
Springfield, MO 65807
Phone (417) 553-1080

300 Singleton Ridge Rd
Conway, SC 29526
Phone (843) 234-6946

394 Singleton Ridge Rd
Conway, SC 29526
Phone (843) 347-8050

4237 River Hills Dr
Ste 170
Little River, SC 29566
Phone (843) 273-0376

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

811 82nd Pkwy
Ste B
Myrtle Beach, SC 29572
Phone (843) 839-4598

8212 Devon Ct
Myrtle Beach, SC 29572
Phone (843) 273-0379

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1349654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650585600000",
    "number": "1306198841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SINGLETON RIDGE RD",
            "address_2": "ATTENTION PATIENT ACCOUNTING",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295269142",
            "telephone_number": "843-234-6946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 82ND PARKWAY STE B",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724653",
            "telephone_number": "843-839-4598",
            "fax_number": "843-839-4599"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8212 Devon Ct",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295724178",
            "country_code": "US",
            "telephone_number": "417-888-0167",
            "fax_number": "417-888-0189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MBUVAH",
        "first_name": "FARAYI",
        "middle_name": "JONNES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-08",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "SC",
            "license": "81715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "817156",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.