NPIMap

Individual provider Active NPI

Dejuania Angela Brown-Rawls, D.O.

  • Hematology & Oncology Physician
  • Myrtle Beach, SC
National Provider Identifier
1730379132
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
39906 Issued in SC
Practice address
8121 Rourk St
Myrtle Beach, SC 29572-4128
Phone
(843) 692-5000
Fax
(843) 692-5010
NPI assigned
Jul 31, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 39906 SC Primary

Addresses

Primary practice location

8121 Rourk St
Myrtle Beach, SC 29572-4128

Mailing address

8121 Rourk St
Att: HR Department
Myrtle Beach, SC 29572-4128
Phone (843) 429-5051

Other practice location 1

817 Farrar Dr
Conway, SC 29526-8747
Phone (843) 234-1660

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
I20170607001981 SC Practitioner - Hematology/Oncology 7113073529 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Philadelphia College of Osteopathic Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Cancer Center LLCGroup PAC ID 1456265503, 22 clinicians

Practice addresses (Care Compare)

8121 Rourk St
Myrtle Beach, SC 29572-4128
Phone (843) 692-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39906SCMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Cancer Center LLC Hematology & Oncology CurrentSince Apr 5, 2017 Accepting new patients
Coastal Cancer Center, LLC Hematology & Oncology Current Accepting new patients
Coastal Cancer Center LLC Hematology & Oncology Current Accepting new patients
Coastal Cancer Center LLC Hematology & Oncology Current Accepting new patients
Coastal Cancer Center LLC Hematology & Oncology CurrentSince Apr 5, 2017 Accepting new patients

Locations

817 Farrar Dr
Conway, SC 29526
Phone (843) 234-1660

3008 Bayboro St
Loris, SC 29569
Phone (843) 756-0932

4620 Highway 17
Murrells Inlet, SC 29576
Phone (843) 357-7357

8121 Rourk St
Myrtle Beach, SC 29572
Phone (843) 692-5000

Organizations & group practices 5

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1185840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1730379132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8121 ROURK ST",
            "address_2": "ATT: HR DEPARTMENT",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724128",
            "telephone_number": "843-429-5051",
            "fax_number": "843-429-5053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8121 ROURK ST",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724128",
            "telephone_number": "843-692-5000",
            "fax_number": "843-692-5010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "817 Farrar Dr",
            "address_purpose": "LOCATION",
            "city": "Conway",
            "state": "SC",
            "postal_code": "295268747",
            "country_code": "US",
            "telephone_number": "843-234-1660",
            "fax_number": "843-234-1661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN-RAWLS",
        "first_name": "DEJUANIA",
        "middle_name": "ANGELA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-31",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "SC",
            "license": "39906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.