Individual provider Active NPI

Brandy Van Heyde, APRN

  • Family Nurse Practitioner
  • Myrtle Beach, SC
National Provider Identifier
1760813190
Registry record updated Dec 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
18614 Issued in SC
Practice address
3236 Holmestown Rd
Ste E1
Myrtle Beach, SC 29588-7495
Phone
(843) 663-8000
NPI assigned
Dec 11, 2013
Last updated
Dec 31, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 18614 SC
Family Nurse Practitioner 363LF0000X 18614 SC Primary

Addresses

Primary practice location

3236 Holmestown Rd
Ste E1
Myrtle Beach, SC 29588-7495

Mailing address

PO Box 547
Little River, SC 29566-0547
Phone (843) 663-8000

Other identifiers 1

IdentifierTypeStateIssuer
NP3002MedicaidSC

Other names 1

  • Brandy Nicole Painter Former name

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
I20150417000846 SC Practitioner - Nurse Practitioner 4486972700 Reassigns benefits to 6 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18614SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Little River Medical Center, Inc. Family CurrentSince Mar 6, 2017 Accepting new patients
Little River Medical Center, Inc CurrentSince Feb 12, 2017 Accepting new patients
Little River Medical Center, Inc. CurrentSince Feb 27, 2017 Accepting new patients
Little River Medical Center, Inc. Family CurrentSince Feb 25, 2017 Accepting new patients
Little River Medical Center Inc Family CurrentSince Apr 6, 2015 Accepting new patients

Locations

4303 Live Oak Dr
Little River, SC 29566
Phone (803) 839-3939

3817 Main St
Loris, SC 29569
Phone (843) 806-2601

3236 Holmestown Rd
Unit E1
Myrtle Beach, SC 29588

3515 Caduceus Dr
Ste B
Myrtle Beach, SC 29588
Phone (843) 651-5689

4220 Carolina Exchange Dr
Myrtle Beach, SC 29579
Phone (843) 663-8013

7724 N Kings Hwy
Myrtle Beach, SC 29572
Phone (843) 839-3939

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": "1386720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451520000000",
    "number": "1760813190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 547",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295660547",
            "telephone_number": "843-663-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3236 HOLMESTOWN RD",
            "address_2": "STE E1",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295887495",
            "telephone_number": "843-663-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN HEYDE",
        "first_name": "BRANDY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-11",
        "last_updated": "2015-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "SC",
            "license": "18614",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "18614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP3002",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRANDY",
            "last_name": "PAINTER",
            "middle_name": "NICOLE",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.