Jcta5221 Enterprises, LLC

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

JCTA5221 ENTERPRISES, LLC

Practice address

6105 N Kings Hwy
Myrtle Beach, SC 29577-2372

Phone

(570) 468-5683

NPI assigned

Dec 3, 2024

Organization subpart

No

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

Authorized official

Name

Jeremy C. PichanyNPI 1568820314

Title

Chief Officer

Phone

(570) 468-5683

Specialties & licenses 1

Addresses

Practitioners 1

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

• Jeremy Pichany

  • Specialist
  • Tafton, PA
  • NPI 1568820314
  NPD Authorized official

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

{
    "created_epoch": "1733184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755907200000",
    "number": "1518773779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "276 PALM COVE CIR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295881405",
            "telephone_number": "570-468-5683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6105 N KINGS HWY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295772372",
            "telephone_number": "570-468-5683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JCTA5221 ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-03",
        "last_updated": "2025-08-23",
        "certification_date": "2025-08-23",
        "status": "A",
        "authorized_official_last_name": "PICHANY",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "CHIEF OFFICER",
        "authorized_official_telephone_number": "570-468-5683"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina L Jardak, MD/MPH
• Blanca Elcy Jardel, SA-C
• Joe N Jarrett Jr., MD
• Claire Jaskowiak
• Imran Ahmad Jawaid, MD
• Jean Koehn (AllCare Therapy Services)
• Jebediah S. Christy, DDS - Myrtle Beach PLLC
• Christian Jefferies, CRNA
• Amanda Grace Jeffords, RN
• Jeffrey H Wallen D.D.S. P.C.

• Adolescent and Children Mental Health Clinic/Center in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Adolescent and Children Mental Health Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.