Organization Active NPI

Carolina Orthotics & Prosthetics of Myrtle Beach LLC

  • Prosthetic/Orthotic Supplier
  • Myrtle Beach, SC
National Provider Identifier
1346209202
Registry record updated Aug 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
CAROLINA ORTHOTICS & PROSTHETICS OF MYRTLE BEACH LLC
Practice address
9714 N Kings Hwy Ste 142
Myrtle Beach, SC 29572-4047
Phone
(843) 497-9558
Fax
(843) 497-9130
NPI assigned
Mar 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2012

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

Authorized official

Name
Clarence Ralph Hooper Jr., CPO
Title
Ceo
Phone
(843) 577-9577

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

9714 N Kings Hwy Ste 142
Myrtle Beach, SC 29572-4047

Mailing address

3465 W Montague Ave Ste 101
N Charleston, SC 29418-5938
Phone (843) 577-9577

Other identifiers 1

IdentifierTypeStateIssuer
DE3311MedicaidSC

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

9714 N Kings Hwy
Ste 142
Myrtle Beach, SC 29572
Phone (843) 497-9552

NPI Registry JSON

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344556800000",
    "number": "1346209202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3465 W MONTAGUE AVE STE 101",
            "city": "N CHARLESTON",
            "state": "SC",
            "postal_code": "294185938",
            "telephone_number": "843-577-9577",
            "fax_number": "843-577-9574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9714 N KINGS HWY STE 142",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724047",
            "telephone_number": "843-497-9558",
            "fax_number": "843-497-9130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA ORTHOTICS & PROSTHETICS OF MYRTLE BEACH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-20",
        "last_updated": "2012-08-10",
        "status": "A",
        "authorized_official_last_name": "HOOPER",
        "authorized_official_first_name": "CLARENCE",
        "authorized_official_middle_name": "RALPH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "843-577-9577",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "CPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DE3311",
            "state": "SC"
        }
    ],
    "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 Aug 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.