NPIMap

Organization Active NPI

J Vance Vandergriff MD, LLC

  • Family Medicine Physician
  • Murrells Inlet, SC
National Provider Identifier
1710319645
Registry record updated Aug 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
21773 Issued in SC
Legal business name
J VANCE VANDERGRIFF MD, LLC
Practice address
3955 Highway 17 Bypass
Murrells Inlet, SC 29576
Phone
(843) 461-0166
NPI assigned
Aug 2, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2013

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

Authorized official

Name
Joseph Vance Vandergriff, M.D.NPI 1659474658
Title
Owner
Phone
(843) 461-0166

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 21773 SC Primary

Addresses

Primary practice location

3955 Highway 17 Bypass
Murrells Inlet, SC 29576

Mailing address

PO Box 1749
Murrells Inlet, SC 29576-1749

Other identifiers 1

IdentifierTypeStateIssuer
T58261MedicaidSC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1375401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375401600000",
    "number": "1710319645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1749",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295761749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3955 HIGHWAY 17 BYPASS",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "29576",
            "telephone_number": "843-461-0166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J VANCE VANDERGRIFF MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-02",
        "last_updated": "2013-08-02",
        "status": "A",
        "authorized_official_last_name": "VANDERGRIFF",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "VANCE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-461-0166",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "21773",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T58261",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrells Inlet, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2013; 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.