NPIMap

Organization Active NPI

Georgetown Physician Associates

  • Orthopaedic Surgery Physician
  • Murrells Inlet, SC
National Provider Identifier
1730505652
Registry record updated Jun 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
GEORGETOWN PHYSICIAN ASSOCIATES
Practice address
4040 Highway 17 Ste 101&105
Murrells Inlet, SC 29576-5098
Phone
(843) 652-8160
Fax
(843) 652-8161
NPI assigned
Mar 17, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2020

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

Authorized official

Name
Elizabeth Sutherland Ward
Title
Evp & Cfo
Phone
(843) 527-7102

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

4040 Highway 17 Ste 101&105
Murrells Inlet, SC 29576-5098

Mailing address

PO Box 421718
Georgetown, SC 29442-4203
Phone (843) 520-8883

Other practice location 1

3515 Caduceus Dr Ste C
Myrtle Beach, SC 29588-2922
Phone (843) 527-1800

Other practice location 2

2185 N Fraser St
Georgetown, SC 29440-6418
Phone (843) 527-1800

Other practice location 3

2200 Crow Ln Ste 203
Myrtle Beach, SC 29577-1663
Phone (843) 848-5200

Other identifiers 4

IdentifierTypeStateIssuer
GP6475MedicaidSC
GP9078MedicaidSC
GP8469MedicaidSC
GP7783MedicaidSC

Other names 1

  • Tidelands Health Orthopaedics Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address credentialing@tidelandshealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130225000067 SC Part B Supplier - Clinic/Group Practice 2365697398 Receives reassigned benefits from 302 practitioners
30 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Murrells Inlet, SC; Myrtle Beach, SC; Pawleys Island, SC; Andrews, SC; Georgetown, SC; Hemingway, SC

Other NPIs on the same Medicare enrollment 30

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 30

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1395014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593043200000",
    "number": "1730505652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421718",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294424203",
            "telephone_number": "843-520-8883",
            "fax_number": "843-652-8422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 HIGHWAY 17 STE 101&105",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295765098",
            "telephone_number": "843-652-8160",
            "fax_number": "843-652-8161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3515 Caduceus Dr Ste C",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295882922",
            "country_code": "US",
            "telephone_number": "843-527-1800",
            "fax_number": "843-527-6528",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2185 N Fraser St",
            "address_purpose": "LOCATION",
            "city": "Georgetown",
            "state": "SC",
            "postal_code": "294406418",
            "country_code": "US",
            "telephone_number": "843-527-1800",
            "fax_number": "843-527-6528",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2200 Crow Ln Ste 203",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295771663",
            "country_code": "US",
            "telephone_number": "843-848-5200",
            "fax_number": "843-848-5205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GEORGETOWN PHYSICIAN ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-17",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "SUTHERLAND",
        "authorized_official_title_or_position": "EVP & CFO",
        "authorized_official_telephone_number": "843-527-7102"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP6475",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP9078",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP8469",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP7783",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@tidelandshealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4040 Highway 17 Ste 101&105",
            "city": "Murrells Inlet",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295765098",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Tidelands Health Orthopaedics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tidelands Health Orthopaedics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.