Individual provider Active NPI

Troy Gibson

  • Adult Care Home Facility
  • Myrtle Beach, SC
National Provider Identifier
1740190891
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
Practice address
243 Empyrean Cir
Myrtle Beach, SC 29588-3002
Phone
(907) 750-4640
NPI assigned
Sep 10, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X Primary

Addresses

Primary practice location

243 Empyrean Cir
Myrtle Beach, SC 29588-3002

Mailing address

243 Empyrean Cir
Myrtle Beach, SC 29588-3002
Phone (907) 750-4640

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1740190891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 EMPYREAN CIR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295883002",
            "telephone_number": "907-750-4640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 EMPYREAN CIR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295883002",
            "telephone_number": "907-750-4640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "TROY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-09-10",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.