Stephanie C. Cobb, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

87785 Issued in SC

Practice address

4022 Postal Way Ste C
Myrtle Beach, SC 29579-3537

Phone

(843) 903-4111

Fax

(843) 903-4242

NPI assigned

Mar 19, 2019

Last updated

Aug 11, 2022By 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

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pediatric Medicine

Education

Lake Erie Col of Osteo Med at Seton Hill Univ, 2019

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)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Conway Hospital, Inc.

  dba Conway Medical Center

  • General Acute Care Hospital
  • Conway, SC
  • NPI 1134172000
  Medicare reassignment Care Compare group NPD
• Conway Hospital, Inc.

  dba CMC Vascular

  • Vascular Surgery Physician
  • Conway, SC
  • NPI 1134910763
  NPD
• Conway Hospital, Inc.

  dba CMC Primary Care Little River

  • Internal Medicine Physician
  • Little River, SC
  • NPI 1558025783
  NPD (past)

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

{
    "created_epoch": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1548729460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SINGLETON RIDGE RD",
            "address_2": "ATTN 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": "4022 POSTAL WAY STE C",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295793537",
            "telephone_number": "843-903-4111",
            "fax_number": "843-903-4242"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6010 Highway 707 Ste 100",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295887321",
            "country_code": "US",
            "telephone_number": "843-293-1005",
            "fax_number": "843-293-1006",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "124 Professional Park Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Conway",
            "state": "SC",
            "postal_code": "295269260",
            "country_code": "US",
            "telephone_number": "843-234-8788",
            "fax_number": "843-234-8787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COBB",
        "first_name": "STEPHANIE",
        "middle_name": "C.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-19",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "87785",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125.074820",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coastal Samaritan Counseling Center
• Coastal Sleep Lab, Inc
• Coastal Springs Counseling LLC
• Coastal Wellness Center, LLC
• Chrystal M Coates-Gal, MD
• Tracy M Cobb, P.T.
• Gwendolyn Patterson Cobbs, M.D.
• Leonard James Cochrane III, DMD
• Rebecca Diane Cody, MD
• Michael Reece Cofer, DDS

• Pediatrics Physician in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Pediatrics Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.