Active NPI
Denise Leigh Tabacheck
- Occupational Therapist
- Conway, SC
National Provider Identifier
1396875548
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 2527
- Practice address
- 3300 4TH Ave
Conway, SC 29527-6002 - Phone
- (843) 248-5728
- NPI assigned
- Mar 6, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 2527 | SC | Primary |
Addresses
Primary practice location
3300 4TH Ave
Conway, SC 29527-6002
Mailing address
1009 Shem Creek Cir
Myrtle Beach, SC 29588-7161
Phone (843) 294-1222
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2527 | SC | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1396875548",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1009 SHEM CREEK CIR",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295887161",
"telephone_number": "843-294-1222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3300 4TH AVE",
"city": "CONWAY",
"state": "SC",
"postal_code": "295276002",
"telephone_number": "843-248-5728"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TABACHECK",
"first_name": "DENISE",
"middle_name": "LEIGH",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "SC",
"license": "2527",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conway, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.