Organization Active NPI

Kingdom Healthcare Center Inc

  • Obstetrics & Gynecology Physician
  • Myrtle Beach, SC
National Provider Identifier
1760158547
Registry record updated Aug 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
KINGDOM HEALTHCARE CENTER INC
Practice address
341 Ocean Commons Dr
Myrtle Beach, SC 29575-5533
Phone
(703) 505-0194
NPI assigned
Aug 20, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2021

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

Authorized official

Name
Gwendolyn Patterson Cobbs, MD
Title
Ceo
Phone
(703) 505-0194

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

341 Ocean Commons Dr
Myrtle Beach, SC 29575-5533

Mailing address

341 Ocean Commons Dr
Myrtle Beach, SC 29575-5533
Phone (703) 505-0194

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1629417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629417600000",
    "number": "1760158547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 OCEAN COMMONS DR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295755533",
            "telephone_number": "703-505-0194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 OCEAN COMMONS DR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295755533",
            "telephone_number": "703-505-0194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGDOM HEALTHCARE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-20",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-20",
        "status": "A",
        "authorized_official_last_name": "PATTERSON COBBS",
        "authorized_official_first_name": "GWENDOLYN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "703-505-0194",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "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 Aug 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.