Organization Active NPI

North Myrtle Beach Family Practice

  • Family Medicine Physician
  • North Myrtle Beach, SC
National Provider Identifier
1619014487
Registry record updated Mar 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9264 Issued in SC
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

Updated by the provider on Mar 5, 2008

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)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
092642MedicaidSC
29670OtherSCMEDCAST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110223000086 SC Part B Supplier - Clinic/Group Practice 0941481048 Receives reassigned benefits from 1 practitioner
Practice locations: North Myrtle Beach, SC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D0252154North Myrtle Beach Family Practice86 Cedar Avenue, North Myrtle Beach, SC 29582Certificate of waiverFeb 2, 2028

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.