Individual provider Active NPI

Courtney Renee Mariner, DO

  • Emergency Medicine Physician
  • Myrtle Beach, SC
National Provider Identifier
1376129254
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
83654 Issued in SC
Practice address
809 82ND Pkwy
Myrtle Beach, SC 29572-4607
Phone
(843) 692-1752
NPI assigned
Mar 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 83654 SC Primary

Addresses

Primary practice location

809 82ND Pkwy
Myrtle Beach, SC 29572-4607

Mailing address

2183 S Finley Rd Apt 1507
Lombard, IL 60148-6482
Phone (720) 272-4315

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
I20230802003890 SC Practitioner - Emergency Medicine 0648677708 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Midwestern University, Chicago College of Osteopathic Med, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acs Primary Care Physicians - Southeast PCGroup PAC ID 5193620714, 409 clinicians

Practice addresses (Care Compare)

806 Hwy 17 S
North Myrtle Beach, SC 29582-3429
Phone (800) 424-3672

Hospital & facility affiliations

  • Grand Strand Regional Medical Center Hospital, Myrtle Beach, SC, CCN 420085

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
83654SCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Health Cheraw Emergency Medicine CurrentSince Jul 1, 2023 Accepting new patients
Acs Primary Care Physicians - Southeast PC Emergency Medicine CurrentSince Jul 1, 2024 Accepting new patients
McLeod Health Cheraw CurrentSince Jul 1, 2023 Accepting new patients

Locations

711 Chesterfield Hwy
Cheraw, SC 29520
Phone (843) 320-3304

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

806 Highway 17 S
North Myrtle Beach, SC 29582
Phone (703) 209-3963

Interoperability endpoints

  • Direct secure messaging: courtney.mariner@hca5.eclinicaldirectplus.com
  • Direct secure messaging: cmariner83905@directmcleodehealth.org

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1376129254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2183 S FINLEY RD APT 1507",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601486482",
            "telephone_number": "720-272-4315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 82ND PKWY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724607",
            "telephone_number": "843-692-1752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINER",
        "first_name": "COURTNEY",
        "middle_name": "RENEE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-22",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "83654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.