Individual provider Active NPI

Daniel B Ward Jr., M.D.

  • Dermatology Physician
  • Myrtle Beach, SC
National Provider Identifier
1306819990
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
22672 Issued in SC
Practice address
8208 Devon CT
Suite B
Myrtle Beach, SC 29572-4178
Phone
(866) 985-3376
Fax
(843) 839-2464
NPI assigned
Feb 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 22672 SC Primary

Addresses

Primary practice location

8208 Devon CT
Suite B
Myrtle Beach, SC 29572-4178

Mailing address

8208 Devon CT
Suite B
Myrtle Beach, SC 29572-4178
Phone (186) 698-5337

Other identifiers 3

IdentifierTypeStateIssuer
AA0265OtherSCPIN
P00145278OtherSCRAILROAD MEDICARE
226721MedicaidSC

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
I20040310000703 SC Practitioner - Dermatology 6800784711

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22672SCMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charlotte Dermatology PA Dermatology Current Accepting new patients
CSC Acquisition, LLC Dermatology Past Accepting new patients

Locations

2630 E 7th St
Ste 200
Charlotte, NC 28204
Phone (704) 927-6166

8208 Devon Ct
#B
Myrtle Beach, SC 29572
Phone (843) 839-2460

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

Organizations & group practices 2

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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1306819990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8208 DEVON CT",
            "address_2": "SUITE B",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724178",
            "telephone_number": "186-698-5337",
            "fax_number": "843-839-2464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8208 DEVON CT",
            "address_2": "SUITE B",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724178",
            "telephone_number": "866-985-3376",
            "fax_number": "843-839-2464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARD",
        "first_name": "DANIEL",
        "middle_name": "B",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "SC",
            "license": "22672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PIN",
            "identifier": "AA0265",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00145278",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "226721",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.