Active NPI
Deborah Craig
- Occupational Therapy Assistant
- Myrtle Beach, SC
National Provider Identifier
1720322233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 3565
- Practice address
- 101 Brightwater Dr
Myrtle Beach, SC 29579-8275 - Phone
- (843) 903-8958
- NPI assigned
- Nov 21, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 3565 | SC | Primary |
| Occupational Therapy Assistant | 224Z00000X | A01351 | MD |
Addresses
Primary practice location
101 Brightwater Dr
Myrtle Beach, SC 29579-8275
Mailing address
112 Cypress Point CT Unit 103
Myrtle Beach, SC 29579-6623
Phone (410) 459-5845
Other practice location 1
1881 Telegraph Rd
Rising Sun, MD 21911-2018
Phone (410) 658-6555
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
| License | State | Type | Specialty |
|---|---|---|---|
| A01351 | MD | MD | Occupational Therapy Assistant |
| 3565 | SC | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1353456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1720322233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "112 CYPRESS POINT CT UNIT 103",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295796623",
"telephone_number": "410-459-5845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 BRIGHTWATER DR",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295798275",
"telephone_number": "843-903-8958"
}
],
"practiceLocations": [
{
"address_1": "1881 Telegraph Rd",
"address_purpose": "LOCATION",
"city": "Rising Sun",
"state": "MD",
"postal_code": "219112018",
"country_code": "US",
"telephone_number": "410-658-6555",
"fax_number": "410-658-9717",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CRAIG",
"first_name": "DEBORAH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-11-21",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "SC",
"license": "3565",
"primary": true
},
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "MD",
"license": "A01351",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Myrtle Beach, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.