Individual provider Active NPI

Nancy Lauren Johnson, FNP

  • Family Nurse Practitioner
  • Myrtle Beach, SC
National Provider Identifier
1629611694
Registry record updated Oct 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
23349 Issued in SC
Practice address
101 McLeod Health Blvd
Myrtle Beach, SC 29579-4477
Phone
(843) 646-8001
Fax
(843) 646-8002
NPI assigned
Oct 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 23349 SC Primary

Addresses

Primary practice location

101 McLeod Health Blvd
Myrtle Beach, SC 29579-4477

Mailing address

101 McLeod Health Blvd Ste 201
Myrtle Beach, SC 29579-4477
Phone (843) 646-8001

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191220001986 SC Practitioner - Nurse Practitioner 0042644239 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Medical University of South Carolina College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
McLeod Physician Associates IIGroup PAC ID 8224031307, 541 clinicians

Practice addresses (Care Compare)

2437 Willwood Dr
Florence, SC 29501-3904
Phone (843) 777-3100

800 E Cheves St
Florence, SC 29506-2649

800 E Cheves St
Florence, SC 29506-2650

800 E Cheves St
Florence, SC 29506-2652

Hospital & facility affiliations

  • McLeod Regional Medical Center-Pee Dee Hospital, Florence, SC, CCN 420051
  • McLeod Loris Hospital Hospital, Loris, SC, CCN 420105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Physician Associates II CurrentSince Oct 28, 2019 Accepting new patients
McLeod Physician Associates II Current Accepting new patients
McLeod Physician Associates II CurrentSince Oct 28, 2019 Accepting new patients
McLeod Physician Associates II Family Past Accepting new patients

Locations

101 S Ravenel St
Ste 300
Florence, SC 29506
Phone (843) 665-4758

506 E Cheves St
#202
Florence, SC 29506

800 E Cheves St
Ste 240
Florence, SC 29506
Phone (843) 777-7950

800 E Cheves St
Ste 480A
Florence, SC 29506
Phone (843) 777-7337

101 McLeod Health Blvd
Ste 201
Myrtle Beach, SC 29579
Phone (843) 646-8001

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1571788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571788800000",
    "number": "1629611694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MCLEOD HEALTH BLVD STE 201",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295794477",
            "telephone_number": "843-646-8001",
            "fax_number": "843-646-8002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MCLEOD HEALTH BLVD",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295794477",
            "telephone_number": "843-646-8001",
            "fax_number": "843-646-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "NANCY",
        "middle_name": "LAUREN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-23",
        "last_updated": "2019-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "23349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.