NPIMap

Individual provider Active NPI

Bennett Haskin Teal, MD

  • Family Medicine Physician
  • Conway, SC
National Provider Identifier
1427677053
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
84208 Issued in SC
Practice address
1301 Creel St
Conway, SC 29527-5018
Phone
(843) 248-4414
Fax
(843) 248-3781
NPI assigned
Apr 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 84208 SC Primary

Addresses

Primary practice location

1301 Creel St
Conway, SC 29527-5018

Mailing address

300 Singleton Ridge Rd
Attention PNS Credentialing
Conway, SC 29526-9142
Phone (843) 234-6946

Other practice location 1

6010 Highway 707
Ste 100
Myrtle Beach, SC 29588-7321
Phone (843) 234-8939

Other identifiers 1

IdentifierTypeStateIssuer
842084MedicaidSC

Other names 1

  • Bennett Leanna Haskin Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230915002714 SC Practitioner - Family Practice 5597182410 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical University of South Carolina College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Conway Hospital IncGroup PAC ID 7113839606, 127 clinicians

Practice addresses (Care Compare)

1301 Creel St
Conway, SC 29527-5018
Phone (843) 248-4414

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Myrtle Beach, SC, CCN 427045
  • Conway Medical Center Hospital, Conway, SC, CCN 420049

Merit-based Incentive Payment System (MIPS)

Final score
52.78 of 100Reported as group
Quality
55.48
Improvement activities
0
Cost
74.21

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
84208SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Conway Hospital, Inc. Family Medicine Current Accepting new patients
Conway Hospital, Inc. CurrentSince Aug 1, 2023 Accepting new patients
Conway Hospital, Inc. CurrentSince Aug 1, 2023 Accepting new patients
Conway Hospital, Inc. Past Accepting new patients

Locations

1301 Creel St
Conway, SC 29527
Phone (843) 248-4414

300 Singleton Ridge Rd
Conway, SC 29526
Phone (843) 234-6946

394 Singleton Ridge Rd
Conway, SC 29526
Phone (843) 347-8050

4237 River Hills Dr
Ste 130
Little River, SC 29566
Phone (843) 234-8675

11899 Highway 707
Unit A8
Murrells Inlet, SC 29576
Phone (843) 651-0791

631 Bellamy Ave
Unit A
Murrells Inlet, SC 29576
Phone (843) 299-1451

1600 Farrow Pkwy
Unit B3
Myrtle Beach, SC 29577
Phone (843) 839-4095

Interoperability endpoints

  • Direct secure messaging: bennett.haskin@conwaymedicalcenter.cernerdirect.com

Organizations & group practices 4

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1586822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1427677053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SINGLETON RIDGE RD",
            "address_2": "ATTENTION PNS CREDENTIALING",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295269142",
            "telephone_number": "843-234-6946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 CREEL ST",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295275018",
            "telephone_number": "843-248-4414",
            "fax_number": "843-248-3781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6010 Highway 707",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295887321",
            "country_code": "US",
            "telephone_number": "843-234-8939",
            "fax_number": "843-234-8959",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TEAL",
        "first_name": "BENNETT",
        "middle_name": "HASKIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-14",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "84208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "842084",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BENNETT",
            "last_name": "HASKIN",
            "middle_name": "LEANNA",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Conway, SC

Sources for this page

Verify at the official NPI Registry.