Amy Langham Canavan, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

86335 Issued in SC

Practice address

124 Professional Park Dr
Suite a
Conway, SC 29526-9260

Phone

(843) 234-8788

Fax

(843) 234-8787

NPI assigned

Jul 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in DC, SC2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Conway Hospital, Inc.

  • General Acute Care Hospital
  • Conway, SC
  • NPI 1134172000

  SC

  Medicare reassignment NPD
• Inova Health Care Services

  • Internal Medicine Physician
  • Falls Church, VA
  • NPI 1952320061

  DC, Pediatrics

  Medicare reassignment NPD
• Conway Hospital, Inc.

  • Vascular Surgery Physician
  • Conway, SC
  • NPI 1134910763
  NPD
• Conway Hospital, Inc.

  • Family Medicine Physician
  • Myrtle Beach, SC
  • NPI 1821756826
  NPD
• Inova Health Care Services

  • Medical Technologist
  • Sterling, VA
  • NPI 1699655589
  NPD
• Inova Health Care Services

  • Diagnostic Radiology Physician
  • Waldorf, MD
  • NPI 1851829550
  NPD
• Southeastern Emergency Physicians of Memphis LLC

  • Emergency Medicine Physician
  • Alton, IL
  • NPI 1437105277

  Emergency Medicine

  NPD (past)

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1376574038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SINGLETON RIDGE RD",
            "address_2": "ATTENTION PATIENT ACCOUNTING",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295269142",
            "telephone_number": "843-234-6946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 PROFESSIONAL PARK DR",
            "address_2": "SUITE A",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295269260",
            "telephone_number": "843-234-8788",
            "fax_number": "843-234-8787"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4022 Postal Way Ste C",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295793537",
            "country_code": "US",
            "telephone_number": "843-903-4111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANAVAN",
        "first_name": "AMY",
        "middle_name": "LANGHAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "SC",
            "license": "86335",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "86335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "863355",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Cain, DPT
• Margaret Cameron, FNP-C
• Heather Causey Campbell, FNP
• Ida Green Campbell, MA, LMSW
• Meghan Campbell, ATC
• Johnny Ray Capps, RPH
• Sharon N Caputo, MSW, LMSW
• Carebuddy of Horry County SC LLC
• Carebuddy of South Carolina LLC
• Caren Stewart & Associates, LLC

• All providers in Conway, SC
• Pediatrics Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.