Individual provider Active NPI

Typhani Gail Smith, APRN

  • Family Nurse Practitioner
  • Myrtle Beach, SC
National Provider Identifier
1649967704
Registry record updated Apr 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
27292 Issued in SD
Practice address
5002 Carolina Forest Blvd
Myrtle Beach, SC 29579-3579
Phone
(888) 968-6386
Fax
(877) 720-5007
NPI assigned
Apr 19, 2023
Last updated
Apr 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2023

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 27292 SD Primary

Addresses

Primary practice location

5002 Carolina Forest Blvd
Myrtle Beach, SC 29579-3579

Mailing address

9600 Cuyamaca St Ste 201
Santee, CA 92071-2692
Phone (619) 258-6200

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
I20230601002595 SC Practitioner - Nurse Practitioner 2264899426 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acs Primary Care Physicians - Southeast PCGroup PAC ID 5193620714, 409 clinicians

Practice addresses (Care Compare)

5050 Hwy 17 Byp S
Myrtle Beach, SC 29588-4500
Phone (843) 839-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Scmwc Inc CurrentSince Aug 1, 2024 Accepting new patients
Acs Primary Care Physicians - Southeast PC CurrentSince Dec 1, 2023 Accepting new patients

Locations

10089 Willow Creek Rd
Ste 200
San Diego, CA 92131
Phone (858) 621-1514

1117 48th Ave N
Ste 124
Myrtle Beach, SC 29577
Phone (619) 289-9356

5050 Highway 17 Byp S
Myrtle Beach, SC 29588
Phone (843) 692-4540

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

Organizations & group practices 3

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

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": "1681862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1649967704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9600 CUYAMACA ST STE 201",
            "city": "SANTEE",
            "state": "CA",
            "postal_code": "920712692",
            "telephone_number": "619-258-6200",
            "fax_number": "619-258-0028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5002 CAROLINA FOREST BLVD",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295793579",
            "telephone_number": "888-968-6386",
            "fax_number": "877-720-5007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TYPHANI",
        "middle_name": "GAIL",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-19",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "27292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.