NPIMap

Organization Active NPI

Atlantic Urology Clinic LLC

  • Surgery Physician
  • Myrtle Beach, SC
National Provider Identifier
1346645306
Registry record updated Jul 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
ATLANTIC UROLOGY CLINIC LLC
Practice address
199 Village Center Blvd
Suite 100
Myrtle Beach, SC 29579-3589
Phone
(843) 236-4330
Fax
(843) 236-5253
NPI assigned
Nov 3, 2014
Last updated
Jul 29, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2019

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

Authorized official

Name
Kim Commins
Title
President
Phone
(239) 931-7277

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

199 Village Center Blvd
Suite 100
Myrtle Beach, SC 29579-3589

Mailing address

2270 Colonial Blvd
Fort Myers, FL 33907-1412
Phone (239) 931-7342

National Provider Directory

National Provider Directory
Tax ID family
Atlantic Urology Clinic LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1414972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564358400000",
    "number": "1346645306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2270 COLONIAL BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071412",
            "telephone_number": "239-931-7342",
            "fax_number": "239-931-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 VILLAGE CENTER BLVD",
            "address_2": "SUITE 100",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295793589",
            "telephone_number": "843-236-4330",
            "fax_number": "843-236-5253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC UROLOGY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-03",
        "last_updated": "2019-07-29",
        "status": "A",
        "authorized_official_last_name": "COMMINS",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-931-7277"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "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 Jul 29, 2019; 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.