Active NPI
Tarzaris Mack
- Social Worker
- Myrtle Beach, SC
National Provider Identifier
1629617485
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 1101 Johnson Ave
Myrtle Beach, SC 29577-1893 - Phone
- (843) 477-0177
- NPI assigned
- Dec 27, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | |||
| Social Worker | 104100000X | SC | Primary |
Addresses
Primary practice location
1101 Johnson Ave
Myrtle Beach, SC 29577-1893
Mailing address
1101 Johnson Ave
Myrtle Beach, SC 29577-1893
Phone (843) 477-0177
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tarzaris.mack@va.gov | Direct | |
| Direct Messaging Address | tarzaris.mack@va.gov |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1577404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597104000000",
"number": "1629617485",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1101 JOHNSON AVE",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295771893",
"telephone_number": "843-477-0177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 JOHNSON AVE",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295771893",
"telephone_number": "843-477-0177"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACK",
"first_name": "TARZARIS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-12-27",
"last_updated": "2020-08-11",
"certification_date": "2020-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "SC",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tarzaris.mack@va.gov",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "2907 Pleasant Valley Blvd",
"city": "Altoona",
"state": "PA",
"country_code": "US",
"postal_code": "166024305",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tarzaris.mack@va.gov",
"affiliation": "N",
"address_1": "1101 Johnson Ave",
"city": "Myrtle Beach",
"state": "SC",
"country_code": "US",
"postal_code": "295771893",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Myrtle Beach, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.