NPIMap

Individual provider Active NPI

Renwick N Goldberg, MD

  • Hematology & Oncology Physician
  • Myrtle Beach, SC
National Provider Identifier
1679566178
Registry record updated Jun 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
12106 Issued in SC
Practice address
8121 Rourk St
Myrtle Beach, SC 29572-4128
Phone
(843) 692-5000
Fax
(843) 692-5015
NPI assigned
Aug 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 12106 SC Primary
Hematology & Oncology Physician 207RH0003X 200100691 NC

Addresses

Primary practice location

8121 Rourk St
Myrtle Beach, SC 29572-4128

Mailing address

8121 Rourk St
Myrtle Beach, SC 29572-4128
Phone (843) 692-5000

Other identifiers 2

IdentifierTypeStateIssuer
7905743MedicaidNC
121068MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100602000709 SC Practitioner - Hematology/Oncology 1951215011 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Coastal Cancer Center LLCGroup PAC ID 1456265503, 22 clinicians

Practice addresses (Care Compare)

8121 Rourk St
Myrtle Beach, SC 29572-4128
Phone (843) 692-5000

Hospital & facility affiliations

  • Grand Strand Regional Medical Center Hospital, Myrtle Beach, SC, CCN 420085
  • Conway Medical Center Hospital, Conway, SC, CCN 420049
  • McLeod Loris Hospital Hospital, Loris, SC, CCN 420105

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
200100691NCMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Cancer Center LLC Hematology & Oncology Current Accepting new patients
Coastal Cancer Center LLC Hematology & Oncology Current Accepting new patients
Coastal Cancer Center LLC Hematology & Oncology CurrentSince Sep 1, 1984 Accepting new patients
Coastal Cancer Center LLC Hematology & Oncology Current Accepting new patients
Coastal Cancer Center, LLC Hematology & Oncology CurrentSince Oct 1, 1997 Accepting new patients
Coastal Cancer Center LLC Hematology & Oncology PastSince Jul 14, 2012 Accepting new patients

Locations

7 Medical Center Dr
Supply, NC 28462
Phone (910) 755-7509

817 Farrar Dr
Conway, SC 29526
Phone (843) 234-1660

3008 Bayboro St
Loris, SC 29569
Phone (843) 756-0932

4620 Highway 17
Murrells Inlet, SC 29576
Phone (843) 357-7357

8121 Rourk St
Myrtle Beach, SC 29572
Phone (843) 692-5000

Interoperability endpoints

  • Direct secure messaging: rgoldberg48891@directmcleodehealth.org

Organizations & group practices 6

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339545600000",
    "number": "1679566178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8121 ROURK ST",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724128",
            "telephone_number": "843-692-5000",
            "fax_number": "843-692-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8121 ROURK ST",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724128",
            "telephone_number": "843-692-5000",
            "fax_number": "843-692-5015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "RENWICK",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2012-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "SC",
            "license": "12106",
            "primary": true
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NC",
            "license": "200100691",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7905743",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121068",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.