Individual provider Active NPI

Elaine Zachary, RN,BSN

  • Community Health Registered Nurse
  • Myrtle Beach, SC
National Provider Identifier
1376963553
Registry record updated Apr 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
39435 Issued in SC
Practice address
800 21St Ave N
Myrtle Beach, SC 29577-7424
Phone
(843) 448-8407
NPI assigned
Apr 25, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X 39435 SC Primary

Addresses

Primary practice location

800 21St Ave N
Myrtle Beach, SC 29577-7424

Mailing address

2688 Forestbrook Rd
Myrtle Beach, SC 29588-7956
Phone (843) 236-0185

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
39435SCMDCommunity Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
State of South Carolina Comptroller General Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1398384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398384000000",
    "number": "1376963553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2688 FORESTBROOK RD",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295887956",
            "telephone_number": "843-236-0185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 21ST AVE N",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295777424",
            "telephone_number": "843-448-8407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACHARY",
        "first_name": "ELAINE",
        "name_prefix": "Mrs.",
        "credential": "RN,BSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-25",
        "last_updated": "2014-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "SC",
            "license": "39435",
            "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 Apr 25, 2014; 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.