Obstetrix Medical Group of Atlanta, LLC

Primary specialty

Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X

Legal business name

OBSTETRIX MEDICAL GROUP OF ATLANTA, LLC

Practice address

199 Village Center Blvd Ste 110
Myrtle Beach, SC 29579-3589

Phone

(843) 236-7878

Fax

(855) 527-5510

NPI assigned

Jun 6, 2024

Organization subpart

No

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

Authorized official

Name

Susanne Heck

Title

President

Phone

(800) 243-3839

Specialties & licenses 1

Addresses

Other names 1

• Maternal Fetal Diagnostic Center of Atlanta Doing business as

Tax ID family

Maternal Fetal Diagnostic Center of Atlanta3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Obstetrix Medical Group of Atlanta, LLC

  • Maternal & Fetal Medicine Physician
  • Myrtle Beach, SC
  • NPI 1154162600
  NPD tax ID
• Obstetrix Medical Group of Atlanta, LLC

  • Maternal & Fetal Medicine Physician
  • Atlanta, GA
  • NPI 1396970109
  NPD tax ID

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

{
    "created_epoch": "1717632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729641600000",
    "number": "1609617166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 CONCORD TER",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232843",
            "telephone_number": "800-243-3839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 VILLAGE CENTER BLVD STE 110",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295793589",
            "telephone_number": "843-236-7878",
            "fax_number": "855-527-5510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OBSTETRIX MEDICAL GROUP OF ATLANTA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-06",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A",
        "authorized_official_last_name": "HECK",
        "authorized_official_first_name": "SUSANNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "800-243-3839"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maternal Fetal Diagnostic Center of Atlanta",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sarah Manglicmot Campos O'Neill, APRN
• Jiajia O'Shea, D.O.
• Sean F O'Shea, D.O
• Oasc, LLC
• Obstetrix Medical Group of Atlanta, LLC
• Ocean Sands Pediatrics
• Ryan Ocean, LMT
• Oceanic Counseling Group LLC
• William J Oconnor, MD
• Kayode Sikiru Odediran, RPH

• All providers in Myrtle Beach, SC
• Maternal & Fetal Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; 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.