Active NPI
Reuben Ryder Tipton, III, M.D.
- Ophthalmology Physician
- Myrtle Beach, SC
National Provider Identifier
1336212083
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 10124
- Practice address
- 900 Medical Cir
Myrtle Beach, SC 29572-4114 - Phone
- (843) 449-6414
- Fax
- (843) 497-0357
- NPI assigned
- Nov 17, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 10124 | SC | Primary |
Addresses
Primary practice location
900 Medical Cir
Myrtle Beach, SC 29572-4114
Mailing address
900 Medical Cir
Myrtle Beach, SC 29572-4114
Phone (843) 449-6414
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191974400000",
"number": "1336212083",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 MEDICAL CIR",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295724114",
"telephone_number": "843-449-6414",
"fax_number": "843-497-0357"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 MEDICAL CIR",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295724114",
"telephone_number": "843-449-6414",
"fax_number": "843-497-0357"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIPTON, III",
"first_name": "REUBEN",
"middle_name": "RYDER",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-17",
"last_updated": "2007-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "SC",
"license": "10124",
"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 Oct 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.