Organization Active NPI

Grand Strand Hearing, LLC

  • Audiologist
  • North Myrtle Beach, SC
National Provider Identifier
1790161669
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
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

Updated by the provider on Jan 29, 2025

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

Authorized official

Name
Tommi Michelle Gray StanleyNPI 1639336332
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)CodeLicenseStatePrimary
AudiologistGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
GP072MedicaidSC

Other names 1

  • Grand Strand Audiology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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 Directory

Locations

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.

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.

Verify at the official NPI Registry.