Active NPI
Shoreline Imaging Center
- Sonography Radiologic Technologist
- Myrtle Beach, SC
National Provider Identifier
1376008052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sonography Radiologic Technologist
- Legal business name
- SHORELINE IMAGING CENTER
- Practice address
- 9261 Highway 707 Ste F
Myrtle Beach, SC 29588-7822 - Phone
- (843) 251-5983
- Fax
- (843) 408-4636
- NPI assigned
- Feb 6, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tiffany Schumal, R.T.(S)(VS)(ARRT)
- Title
- Owner/Administrator
- Phone
- (843) 251-5983
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Ultrasound Physician | 2085U0001X | |||
| Sonography Radiologic Technologist | 2471S1302X | Primary | ||
| Vascular Sonography Radiologic Technologist | 2471V0105X |
Addresses
Primary practice location
9261 Highway 707 Ste F
Myrtle Beach, SC 29588-7822
Mailing address
9261 Highway 707 Ste F
Myrtle Beach, SC 29588-7822
Phone (843) 251-5983
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190515000287 | SC | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 1951644962 | Practice locations: Myrtle Beach, SC |
National Provider Directory
National Provider DirectoryLocations
9261 Highway 707
Ste F
Myrtle Beach, SC 29588
Phone (843) 251-5983
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Diagnostic Radiology Physician
- Goldsboro, NC
- NPI 1710912191
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549411200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1686700800000",
"number": "1376008052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9261 HIGHWAY 707 STE F",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295887822",
"telephone_number": "843-251-5983",
"fax_number": "843-408-4636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9261 HIGHWAY 707 STE F",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295887822",
"telephone_number": "843-251-5983",
"fax_number": "843-408-4636"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SHORELINE IMAGING CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2019-02-06",
"last_updated": "2023-06-14",
"certification_date": "2023-06-14",
"status": "A",
"authorized_official_last_name": "SCHUMAL",
"authorized_official_first_name": "TIFFANY",
"authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
"authorized_official_telephone_number": "843-251-5983",
"authorized_official_credential": "R.T.(S)(VS)(ARRT)"
},
"taxonomies": [
{
"code": "2085U0001X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Radiology, Diagnostic Ultrasound",
"state": null,
"license": null,
"primary": false
},
{
"code": "2471S1302X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Radiologic Technologist, Sonography",
"state": null,
"license": null,
"primary": true
},
{
"code": "2471V0105X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Radiologic Technologist, Vascular Sonography",
"state": null,
"license": null,
"primary": false
}
],
"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 Jun 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.