Active NPI
Grand Strand Hearing, LLC
- Audiologist
- North Myrtle Beach, SC
National Provider Identifier
1790161669
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- Legal business name
- GRAND STRAND HEARING, LLC
- Practice address
- 1016 2ND Ave N
Suite 102
North Myrtle Beach, SC 29582-3287 - Phone
- (843) 732-6090
- Fax
- (843) 491-3573
- NPI assigned
- Aug 3, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tommi Michelle Gray Stanley
- Title
- Owner
- Phone
- (843) 732-6090
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | Primary |
Addresses
Primary practice location
1016 2ND Ave N
Suite 102
North Myrtle Beach, SC 29582-3287
Mailing address
1016 2ND Ave N
Suite 102
North Myrtle Beach, SC 29582-3287
Phone (843) 732-6090
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GP072 | Medicaid | SC |
Other names 1
- Grand Strand Audiology
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150812007539 | SC | Part B Supplier - Clinic/Group Practice | 2365757937 |
Receives reassigned benefits from 2 practitioners Practice locations: North Myrtle Beach, SC |
National Provider Directory
National Provider DirectoryLocations
1016 2nd Ave N
Ste 102
North Myrtle Beach, SC 29582
Phone (843) 491-3572
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Audiologist
- North Myrtle Beach, SC
- NPI 1639336332
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438560000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1738108800000",
"number": "1790161669",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1016 2ND AVE N",
"address_2": "SUITE 102",
"city": "NORTH MYRTLE BEACH",
"state": "SC",
"postal_code": "295823287",
"telephone_number": "843-732-6090",
"fax_number": "843-491-3573"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1016 2ND AVE N",
"address_2": "SUITE 102",
"city": "NORTH MYRTLE BEACH",
"state": "SC",
"postal_code": "295823287",
"telephone_number": "843-732-6090",
"fax_number": "843-491-3573"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GRAND STRAND HEARING, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2015-08-03",
"last_updated": "2025-01-29",
"certification_date": "2025-01-29",
"status": "A",
"authorized_official_last_name": "GRAY STANLEY",
"authorized_official_first_name": "TOMMI",
"authorized_official_middle_name": "MICHELLE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "843-732-6090"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Audiologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GP072",
"state": "SC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Grand Strand Audiology",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in North Myrtle Beach, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; 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.