Individual provider Active NPI

Myrtle Anne Staples, APRN

  • Ambulatory Women's Health Care Registered Nurse
  • Mount Pleasant, SC
National Provider Identifier
1710183363
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Women's Health Care Registered NurseTaxonomy code 163WW0101X
License
355 Issued in SC
Practice address
1189 Iron Bridge Dr
Suite 100
Mt Pleasant, SC 29466-7401
Phone
(843) 856-1210
Fax
(843) 856-1189
NPI assigned
Jun 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Women's Health Care Registered Nurse 163WW0101X 355 SC Primary

Addresses

Primary practice location

1189 Iron Bridge Dr
Suite 100
Mt Pleasant, SC 29466-7401

Mailing address

1189 Iron Bridge Dr
Suite 100
Mt Pleasant, SC 29466-7401
Phone (843) 856-1210

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

State licenses

LicenseStateTypeSpecialty
355SCMDAmbulatory Women's Health Care Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710183363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1189 IRON BRIDGE DR",
            "address_2": "SUITE 100",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294667401",
            "telephone_number": "843-856-1210",
            "fax_number": "843-856-1189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1189 IRON BRIDGE DR",
            "address_2": "SUITE 100",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294667401",
            "telephone_number": "843-856-1210",
            "fax_number": "843-856-1189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAPLES",
        "first_name": "MYRTLE",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WW0101X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Women's Health Care, Ambulatory",
            "state": "SC",
            "license": "355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.