Individual provider Active NPI

Justin Schevers, DO

  • Emergency Medicine Physician
  • Myrtle Beach, SC
National Provider Identifier
1407484835
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2023-00882 Issued in NC
Practice address
802 82ND Parkway
Myrtle Beach, SC 29572
Phone
(772) 692-1904
NPI assigned
Mar 31, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2023-00882 NC Primary
Student in an Organized Health Care Education/Training ProgramGroup: 193400000X SINGLE SPECIALTY GROUP 390200000X

Addresses

Primary practice location

802 82ND Parkway
Myrtle Beach, SC 29572

Mailing address

1315 N Duval St Apt a
Tallahassee, FL 32303-5693
Phone (772) 370-4816

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 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

Enrollment IDStateProvider typePAC IDDetails
I20221005003736 SC Practitioner - Emergency Medicine 3274959309 Reassigns benefits to 1 organization
I20230731003159 NC Practitioner - Emergency Medicine 3274959309 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Alabama College of Osteopathic Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Coverage LLCGroup PAC ID 3072412592, 761 clinicians

Practice addresses (Care Compare)

288 S Ridgecrest Ave
Rutherfordton, NC 28139-2838
Phone (828) 286-5000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Health Cheraw Single Specialty CurrentSince Sep 7, 2022 Accepting new patients
McLeod Health Cheraw Single Specialty CurrentSince Sep 7, 2022 Accepting new patients
Emergency Coverage, LLC Single Specialty CurrentSince Jul 1, 2023 Accepting new patients
Southeastern Emergency Physicians LLC Single Specialty CurrentSince Nov 1, 2023 Accepting new patients
Emergency Coverage Services, PC Single Specialty Past Accepting new patients

Locations

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

262 Leroy George Dr
Clyde, NC 28721
Phone (828) 452-8210

615 Ridge Rd
Roxboro, NC 27573
Phone (336) 503-5699

288 S Ridgecrest Ave
Rutherfordton, NC 28139
Phone (252) 808-6000

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

Organizations & group practices 5

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 2

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": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1407484835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 N DUVAL ST APT A",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323035693",
            "telephone_number": "772-370-4816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 82ND PARKWAY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "29572",
            "telephone_number": "772-692-1904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHEVERS",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-31",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2023-00882",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.