Melissa H Gray, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

3604 Issued in SC

Practice address

2200 Crow LN Ste 201
Myrtle Beach, SC 29577-1663

Phone

(843) 848-5000

NPI assigned

May 10, 2006

Last updated

Mar 12, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Georgetown Physician Associates, LLCGroup PAC ID 2365697398, 221 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Georgetown Physician Associates, LLC

  dba Tidelands Health Family Medicine

  • Family Medicine Physician
  • Murrells Inlet, SC
  • NPI 1235475930
  Medicare reassignment Care Compare group NPD
• Georgetown Physician Associates LLC

  dba Tidelands Health Group

  • Family Medicine Physician
  • Georgetown, SC
  • NPI 1881410587
  NPD
• Georgetown Physician Associates, LLC

  dba Tidelands Health Rehabilitation Services

  • Physical Therapy Clinic/Center
  • Myrtle Beach, SC
  • NPI 1124673793
  NPD
• Atlantic Physical Therapy & Rehabilitation, Inc

  • Occupational Therapy Assistant
  • Myrtle Beach, SC
  • NPI 1053363267

  Physical Therapist

  NPD (past)
• Georgetown Physician Services, LLC

  dba Waccamaw Family Medicine

  • Family Medicine Physician
  • Pawley's Island, SC
  • NPI 1962691402
  NPD (past)

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615507200000",
    "number": "1437109774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421718",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294424203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 CROW LN STE 201",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295771663",
            "telephone_number": "843-848-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3650 Coalition Dr",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295886183",
            "country_code": "US",
            "telephone_number": "843-293-7713",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAY",
        "first_name": "MELISSA",
        "middle_name": "H",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "8268",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "3604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TH0869",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "records@tidelands-health.direct.kno2fy.com",
            "affiliation": "N",
            "address_1": "2200 Crow Ln Ste 201",
            "city": "Myrtle Beach",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295771663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• John P Grant, D.C.
• Pamela Grant
• Anthony John Grasso, ADC
• Ellalee F. Gravely, LPC, NCC
• Frances Graves
• Stephanie N Grear, SLP
• Jack L Green Jr., DDS MSD
• Melissa Ann Green, RD
• James Chad Greene, MD
• Jessica Yvonne Greene, LPC

• Physical Therapist in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.