Active NPI
North Myrtle Beach Family Practice
- Family Medicine Physician
- North Myrtle Beach, SC
National Provider Identifier
1619014487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 9264
- Legal business name
- NORTH MYRTLE BEACH FAMILY PRACTICE
- Practice address
- 86 Cedar Ave
North Myrtle Beach, SC 29582-3112 - Phone
- (843) 249-2451
- Fax
- (843) 249-4100
- NPI assigned
- Jan 31, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. John Garnett Ramslattorn Jr., MD
- Title
- President
- Phone
- (843) 249-2451
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 9264 | SC | Primary |
Addresses
Primary practice location
86 Cedar Ave
North Myrtle Beach, SC 29582-3112
Mailing address
86 Cedar Ave
North Myrtle Beach, SC 29582-3112
Phone (843) 249-2451
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 092642 | Medicaid | SC | |
| 29670 | Other | SC | MEDCAST |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 42D0252154 | North Myrtle Beach Family Practice | Certificate of waiver | Feb 2, 2028 |
National Provider Directory
National Provider DirectoryLocations
86 Cedar Ave
North Myrtle Beach, SC 29582
Phone (843) 249-2451
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- North Myrtle Beach, SC
- NPI 1437277753
-
- Family Medicine Physician
- Abbeville, SC
- NPI 1407988868
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170201600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1204675200000",
"number": "1619014487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "86 CEDAR AVE",
"city": "NORTH MYRTLE BEACH",
"state": "SC",
"postal_code": "295823112",
"telephone_number": "843-249-2451",
"fax_number": "843-249-4100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "86 CEDAR AVE",
"city": "NORTH MYRTLE BEACH",
"state": "SC",
"postal_code": "295823112",
"telephone_number": "843-249-2451",
"fax_number": "843-249-4100"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTH MYRTLE BEACH FAMILY PRACTICE",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-31",
"last_updated": "2008-03-05",
"status": "A",
"authorized_official_last_name": "RAMSLATTORN",
"authorized_official_first_name": "JOHN",
"authorized_official_middle_name": "GARNETT",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "843-249-2451",
"authorized_official_name_prefix": "Dr.",
"authorized_official_name_suffix": "Jr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "SC",
"license": "9264",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "092642",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCAST",
"identifier": "29670",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in North Myrtle Beach, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; 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.