Carly Nicole Sedwick, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2820 Issued in SC

Practice address

320 E North Ave Ste 401
Pittsburgh, PA 15212-4756

Phone

(412) 359-4352

Fax

(412) 359-8285

NPI assigned

Jul 9, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grand Strand Surgical Specialists LLCGroup PAC ID 4082770656, 57 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Grand Strand Regional Medical Center Hospital, Myrtle Beach, SC, CCN 420085

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Grand Strand Surgical Specialists, LLC

  • Surgery Physician
  • Myrtle Beach, SC
  • NPI 1841465804
  Medicare reassignment Care Compare group

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

• Grand Strand Regional Medical Center LLC

  • General Acute Care Hospital
  • Myrlte Beach, SC
  • NPI 1083668669
  Care Compare affiliation

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

{
    "created_epoch": "1436400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1659754554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 DOUG WHITE DR STE 430",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724182",
            "telephone_number": "843-903-6459",
            "fax_number": "843-839-0218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 E NORTH AVE STE 401",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152124756",
            "telephone_number": "412-359-4352",
            "fax_number": "412-359-8285"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "920 Doug White Dr Ste 430",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295724182",
            "country_code": "US",
            "telephone_number": "843-903-6459",
            "fax_number": "843-839-0218",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEDWICK",
        "first_name": "CARLY",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-09",
        "last_updated": "2022-01-04",
        "certification_date": "2020-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA058189",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "2820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103151404",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "CARLY.SEDWICK@hca5.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "920 Doug White Dr Ste 430",
            "city": "Myrtle Beach",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295724182",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christine Sedam, OTR
• Faith Marie Sedlak, PHARM D
• Cheryl Sedlock, LMT
• Mara Jean Sedlock
• Rebekah A Sedlock, MSW,LSW
• See Inc
• Seebacher Family Chiropractic Center LLC
• Brian Seebacher, DC
• Richard M Seecoff, MD
• Seed in the Soot LLC

• Physician Assistant in Pittsburgh, PA
• Providers in Pittsburgh, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.