Individual provider Active NPI

Anna Elizabeth Lark, PA-C

  • Physician Assistant
  • Myrtle Beach, SC
National Provider Identifier
1508646688
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4865 Issued in SC
Practice address
108 Finnegan CT
Myrtle Beach, SC 29579-4205
Phone
(843) 903-9993
NPI assigned
Oct 4, 2023
Last updated
Feb 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4865 SC Primary

Addresses

Primary practice location

108 Finnegan CT
Myrtle Beach, SC 29579-4205

Mailing address

108 Finnegan CT
Myrtle Beach, SC 29579-4205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231222003093 SC Practitioner - Physician Assistant 7810347374 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

101 McLeod Health Blvd
Suite 201
Myrtle Beach, SC 29579-4477
Phone (843) 646-8001

107 McLeod Health Blvd
Myrtle Beach, SC 29579-4477

555 E Cheves St
Florence, SC 29506-2617
Phone (843) 777-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4865SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Regional Medical Center of the Pee Dee, Inc CurrentSince Sep 15, 2024 Accepting new patients
McLeod Physician Associates II CurrentSince Dec 3, 2023 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc CurrentSince Sep 15, 2024 Accepting new patients
McLeod Physician Associates II CurrentSince Dec 3, 2023 Accepting new patients

Locations

555 E Cheves St
Florence, SC 29506
Phone (843) 662-5233

800 E Cheves St
Ste 240
Florence, SC 29506
Phone (843) 777-7950

800 E Cheves St
Ste 480A
Florence, SC 29506
Phone (843) 777-7337

101 McLeod Health Blvd
Ste 201
Myrtle Beach, SC 29579
Phone (843) 646-8001

108 Finnegan Ct
Myrtle Beach, SC 29579
Phone (843) 903-9993

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1696377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1508646688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 FINNEGAN CT",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295794205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 FINNEGAN CT",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295794205",
            "telephone_number": "843-903-9993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARK",
        "first_name": "ANNA",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-04",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "4865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.