Individual provider Active NPI

Christopher Garrett Boullion, D.O.

  • Orthopaedic Surgery Physician
  • Myrtle Beach, SC
National Provider Identifier
1730201112
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
1429 Issued in SC
Practice address
920 Doug White Dr Ste 130
Myrtle Beach, SC 29572-4180
Phone
(843) 848-1440
Fax
(843) 839-1654
NPI assigned
Apr 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 5101016197 MI
Orthopaedic Surgery Physician 207X00000X 1429 SC Primary

Addresses

Primary practice location

920 Doug White Dr Ste 130
Myrtle Beach, SC 29572-4180

Mailing address

920 Doug White Dr Ste 130
Myrtle Beach, SC 29572-4180
Phone (843) 848-1440

Other identifiers 1

IdentifierTypeStateIssuer
01429100MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address CHRISTOPHER.BOULLION@hca5.eclinicaldirectplus.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101015001284 SC Practitioner - Orthopedic Surgery 5193918613 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Midwestern University, Chicago College of Osteopathic Med, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grand Strand Specialty Associates, LLCGroup PAC ID 0648451344, 29 clinicians

Practice addresses (Care Compare)

809 82ND Pkwy
Myrtle Beach, SC 29572-4607
Phone (843) 692-1000

920 Doug White Dr
Suite 130
Myrtle Beach, SC 29572-4120
Phone (843) 848-1440

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.55 of 100Reported as group
Quality
73.67
Promoting interoperability
99
Improvement activities
40
Cost
78.99

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Spinal fusion1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1429SCMDOptician
5101016197MIMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Strand Specialty Associates, LLC Orthopaedic Surgery CurrentSince Sep 1, 2011 Accepting new patients

Locations

4237 River Hills Dr
Ste 150
Little River, SC 29566
Phone (843) 281-2778

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

8170 Rourk St
Ste 150
Myrtle Beach, SC 29572
Phone (843) 449-2336

8170 Rourk St
Myrtle Beach, SC 29572
Phone (843) 449-1963

849 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 449-2336

920 Doug White Dr
Ste 130
Myrtle Beach, SC 29572
Phone (843) 497-6348

Interoperability endpoints

  • Direct secure messaging: christopher.boullion@hca5.eclinicaldirectplus.com

Organizations & group practices 1

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 9

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

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1730201112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 DOUG WHITE DR STE 130",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724180",
            "telephone_number": "843-848-1440",
            "fax_number": "843-839-1654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 DOUG WHITE DR STE 130",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724180",
            "telephone_number": "843-848-1440",
            "fax_number": "843-839-1654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULLION",
        "first_name": "CHRISTOPHER",
        "middle_name": "GARRETT",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2022-01-26",
        "certification_date": "2020-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "5101016197",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "SC",
            "license": "1429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01429100",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "CHRISTOPHER.BOULLION@hca5.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "920 Doug White Dr Ste 130",
            "city": "Myrtle Beach",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295724180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.