City of Goose Creek

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

18201 Issued in SC

Legal business name

CITY OF GOOSE CREEK

Practice address

519 N Goose Creek Blvd
Goose Creek, SC 29445-2962

Phone

(843) 797-6220

Fax

(843) 863-5208

NPI assigned

Jul 5, 2005

Last updated

Sep 26, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Tyler D Howanyk

Title

Finance Director

Phone

(843) 797-6220

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727308800000",
    "number": "1417954587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1768",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294451768",
            "telephone_number": "843-797-6220",
            "fax_number": "843-572-0155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 N GOOSE CREEK BLVD",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294452962",
            "telephone_number": "843-797-6220",
            "fax_number": "843-863-5208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF GOOSE CREEK",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-05",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A",
        "authorized_official_last_name": "HOWANYK",
        "authorized_official_first_name": "TYLER",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "843-797-6220",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "SC",
            "license": "18201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "502897",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Faysal Chaya, PA-C
• Vicki Cheng, DPT
• Matthew Christie, D.D.S.
• Chih Tien Chuang, PHARM.D.
• Brian Ciaccia, PT, DPT
• Claire Brooke Sleep Center LLC
• Jeannine M Clearman, LMT
• Clemson Sports Medicine and Rehabilitation, Inc (Goose Creek Physical Therapy)
• Tanner Cline
• Coastal Internal Medicine & Geriatrics LLC

• Land Ambulance in Goose Creek, SC
• Providers in Goose Creek, SC by specialty
• Land Ambulance in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; 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.