NPIMap

Organization Active NPI

Grand Strand Surgical Specialists, LLC

  • Surgery Physician
  • Myrtle Beach, SC
National Provider Identifier
1841465804
Registry record updated Jan 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
GRAND STRAND SURGICAL SPECIALISTS, LLC
Practice address
849 82ND Pkwy
Myrtle Beach, SC 29572-4614
Phone
(843) 497-6348
Fax
(843) 497-6351
NPI assigned
Apr 29, 2008
Last updated
Jan 29, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2020

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

Authorized official

Name
Mr. Ali Faile
Title
VP HCA Physician Services
Phone
(843) 497-6348

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X NU
Surgery Physician 208600000X NU Primary
Surgical Critical Care Physician 2086S0102X NU
Pediatric Surgery Physician 2086S0120X NU
Plastic and Reconstructive Surgery Physician 2086S0122X NU
Trauma Surgery Physician 2086S0127X NU
Vascular Surgery Physician 2086S0129X NU

Addresses

Primary practice location

849 82ND Pkwy
Myrtle Beach, SC 29572-4614

Mailing address

2000 Health Park Dr
Brentwood, TN 37027-4525
Phone (615) 372-5426

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090305000535 SC Part B Supplier - Clinic/Group Practice 4082770656 Receives reassigned benefits from 70 practitioners
Practice locations: Myrtle Beach, SC; Summerville, SC; Murrells Inlet, SC; Little River, SC; Conway, SC; Charleston, SC

National Provider Directory

National Provider Directory
Tax ID family
Grand Strand Surg Spec2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

199 Village Center Blvd
Ste 100
Myrtle Beach, SC 29579
Phone (843) 236-4330

4600 Oleander Dr
Ste A
Myrtle Beach, SC 29577
Phone (843) 467-2300

4630 Hwy 17 Byp S
Myrtle Beach, SC 29588
Phone (843) 848-1440

8170 Rourk St
Ste 150
Myrtle Beach, SC 29572
Phone (843) 449-2336

8210 Devon Ct
Myrtle Beach, SC 29572
Phone (843) 497-7772

920 Doug White Dr
Ste 210
Myrtle Beach, SC 29572
Phone (843) 497-6348

920 Doug White Dr
Ste 420
Myrtle Beach, SC 29572
Phone (843) 353-5360

920 Doug White Dr
Ste 510
Myrtle Beach, SC 29572
Phone (843) 497-7772

295A Midland Pkwy
Ste 260
Summerville, SC 29485
Phone (843) 695-2700

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 104

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 104

NPI Registry JSON

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580256000000",
    "number": "1841465804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 HEALTH PARK DR",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274525",
            "telephone_number": "615-372-5426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "849 82ND PKWY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724614",
            "telephone_number": "843-497-6348",
            "fax_number": "843-497-6351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND STRAND SURGICAL SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-29",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A",
        "authorized_official_last_name": "FAILE",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "VP HCA PHYSICIAN SERVICES",
        "authorized_official_telephone_number": "843-497-6348",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "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 Jan 29, 2020; 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.