Individual provider Active NPI

Vicki Grigg Chacon, FNP-C

  • Nurse Practitioner
  • Myrtle Beach, SC
National Provider Identifier
1750922233
Registry record updated Dec 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
23522 Issued in SC
Practice address
1201 48TH Ave N
Myrtle Beach, SC 29577-5452
Phone
(843) 450-4429
NPI assigned
Oct 4, 2019
Last updated
Dec 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 23522 SC Primary

Addresses

Primary practice location

1201 48TH Ave N
Myrtle Beach, SC 29577-5452

Mailing address

1201 48TH Ave N
Myrtle Beach, SC 29577-5452
Phone (704) 300-5473

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230630000109 SC Practitioner - Nurse Practitioner 1850750423 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

630 Chestnut Rd
Myrtle Beach, SC 29572-5502
Phone (843) 945-1452

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Family Services Inc CurrentSince Jul 28, 2024 Accepting new patients
Sandhills Intergrated Care, Inc. CurrentSince Jan 13, 2023 Accepting new patients
Advanced Practice Mental Health and Wellness of South Carolina L.L.C. Nurse Practitioner CurrentSince Sep 3, 2023 Accepting new patients
Sandhills Intergrated Care, Inc. PastSince May 16, 2022 Accepting new patients
Wright Directions, LLC Past Accepting new patients
Robin H Starr Nurse Practitioner PastSince Sep 3, 2023 Accepting new patients

Locations

3997 Meeting St
#B
Loris, SC 29569
Phone (843) 945-1452

4123 Meeting St
Ste A
Loris, SC 29569
Phone (843) 756-3008

630 Chestnut Rd
Myrtle Beach, SC 29572
Phone (843) 945-1452

2406 Madison Dr
North Myrtle Beach, SC 29582
Phone (843) 663-0748

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1570147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764547200000",
    "number": "1750922233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 48TH AVE N",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295775452",
            "telephone_number": "704-300-5473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 48TH AVE N",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295775452",
            "telephone_number": "843-450-4429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHACON",
        "first_name": "VICKI",
        "middle_name": "GRIGG",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-04",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "23522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.