NPIMap

Individual provider Active NPI

Emily B Johnson

  • Family Nurse Practitioner
  • Conway, SC
National Provider Identifier
1700603172
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
30064 Issued in SC
Practice address
2376 Cypress Cir Ste 102
Conway, SC 29526-8964
Phone
(843) 347-8953
Fax
(843) 347-0226
NPI assigned
Sep 25, 2024
Last updated
Apr 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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 30064 SC Primary

Addresses

Primary practice location

2376 Cypress Cir Ste 102
Conway, SC 29526-8964

Mailing address

300 Singleton Ridge Rd
Attention Credentialing
Conway, SC 29526-9142
Phone (843) 234-6946

Other practice location 1

6010 Highway 707 Ste 300
Myrtle Beach, SC 29588-7321
Phone (843) 347-8953

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
I20250417003558 SC Practitioner - Nurse Practitioner 7911422324 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Conway Hospital IncGroup PAC ID 7113839606, 127 clinicians

Practice addresses (Care Compare)

2376 Cypress Cir
Suite 102
Conway, SC 29526-8964
Phone (843) 347-8953

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Conway Hospital, Inc. CurrentSince May 1, 2025 Accepting new patients
Conway Hospital, Inc. CurrentSince May 1, 2025 Accepting new patients
Conway Hospital, Inc. Family Past Accepting new patients

Locations

2376 Cypress Cir
Ste 102
Conway, SC 29526
Phone (843) 347-8953

300 Singleton Ridge Rd
Conway, SC 29526
Phone (843) 234-6946

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1727222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1700603172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SINGLETON RIDGE RD",
            "address_2": "ATTENTION CREDENTIALING",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295269142",
            "telephone_number": "843-234-6946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2376 CYPRESS CIR STE 102",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295268964",
            "telephone_number": "843-347-8953",
            "fax_number": "843-347-0226"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6010 Highway 707 Ste 300",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295887321",
            "country_code": "US",
            "telephone_number": "843-347-8953",
            "fax_number": "843-347-0226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "EMILY",
        "middle_name": "B",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-25",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "30064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, SC

Sources for this page

Verify at the official NPI Registry.