NPIMap

Individual provider Active NPI

Randall Nix Goodroe, M.D.

  • Interventional Cardiology Physician
  • Myrtle Beach, SC
National Provider Identifier
1730271602
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
23353 Issued in SC
Practice address
920 Doug White Dr Ste 510
Myrtle Beach, SC 29572-4183
Phone
(843) 497-7772
Fax
(843) 848-7530
NPI assigned
Sep 29, 2006
Last updated
Jan 26, 2022By the provider in NPPES
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
Internal Medicine Physician 207R00000X 23353 SC
Interventional Cardiology Physician 207RI0011X 23353 SC Primary

Addresses

Primary practice location

920 Doug White Dr Ste 510
Myrtle Beach, SC 29572-4183

Mailing address

920 Doug White Dr Ste 510
Myrtle Beach, SC 29572-4183
Phone (843) 497-7772

Other identifiers 2

IdentifierTypeStateIssuer
383781722OtherSCPRACTICE TAX ID
233535MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address RANDALL.GOODROE@hca5.eclinicaldirectplus.com

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
I20050929000297 SC Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 4981639887 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Internal Medicine
Education
Medical University of South Carolina College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grand Strand Surgical Specialists LLCGroup PAC ID 4082770656, 57 clinicians

Practice addresses (Care Compare)

4237 River Hills Dr
Suite 150
Little River, SC 29566-6446
Phone (843) 281-2778

809 82ND Pkwy
Myrtle Beach, SC 29572-4607
Phone (843) 848-1440

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as individual
Promoting interoperability
99
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting195
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Strand Surgical Specialists, LLC CurrentSince Apr 1, 2014 Accepting new patients
Coastal Carolina Primary Care, LLC Past Accepting new patients

Locations

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

8210 Devon Ct
Myrtle Beach, SC 29572
Phone (843) 497-7772

920 Doug White Dr
Myrtle Beach, SC 29572

920 Doug White Dr
Ste 510
Myrtle Beach, SC 29572
Phone (843) 497-7772

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • Direct secure messaging: randall.goodroe@hca5.eclinicaldirectplus.com

Organizations & group practices 2

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 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1730271602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 DOUG WHITE DR STE 510",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724183",
            "telephone_number": "843-497-7772",
            "fax_number": "843-848-7530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 DOUG WHITE DR STE 510",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724183",
            "telephone_number": "843-497-7772",
            "fax_number": "843-848-7530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODROE",
        "first_name": "RANDALL",
        "middle_name": "NIX",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2022-01-26",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "23353",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "SC",
            "license": "23353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRACTICE TAX ID",
            "identifier": "383781722",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "233535",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "RANDALL.GOODROE@hca5.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "920 Doug White Dr Ste 510",
            "city": "Myrtle Beach",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295724183",
            "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.