Organization Active NPI

M Alexander Staton MD PA

  • Psychiatry Physician
  • Myrtle Beach, SC
National Provider Identifier
1417070640
Registry record updated May 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
M ALEXANDER STATON MD PA
Practice address
1601 N Oak St
Suite 206 Myrtle Offices
Myrtle Beach, SC 29577-3579
Phone
(843) 448-2824
NPI assigned
Apr 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2008

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

Authorized official

Name
Sandra Staton
Title
Office Manager
Phone
(843) 448-2824

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

1601 N Oak St
Suite 206 Myrtle Offices
Myrtle Beach, SC 29577-3579

Mailing address

1601 N Oak St
Suite 206 Myrtle Offices
Myrtle Beach, SC 29577-3579
Phone (843) 448-2824

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120322000653 SC Part B Supplier - Clinic/Group Practice 3779743034 Receives reassigned benefits from 1 practitioner
Practice locations: Myrtle Beach, SC

National Provider Directory

National Provider Directory

Locations

1601 N Oak St
Ste 206
Myrtle Beach, SC 29577
Phone (843) 448-2824

2513 N Oak St
Ste 209
Myrtle Beach, SC 29577
Phone (843) 448-2824

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211414400000",
    "number": "1417070640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 N OAK ST",
            "address_2": "SUITE 206 MYRTLE OFFICES",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295773579",
            "telephone_number": "843-448-2824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 N OAK ST",
            "address_2": "SUITE 206 MYRTLE OFFICES",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295773579",
            "telephone_number": "843-448-2824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M ALEXANDER STATON MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2008-05-22",
        "status": "A",
        "authorized_official_last_name": "STATON",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "843-448-2824"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "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 May 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.