NPIMap

Organization Active NPI

Georgetown Physician Associates, LLC

Doing business as Tidelands Waccamaw Orthopaedics and Spine

  • Orthopaedic Surgery Physician
  • Murrells Inlet, SC
National Provider Identifier
1851705206
Registry record updated May 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
GEORGETOWN PHYSICIAN ASSOCIATES, LLC
Doing business as
Tidelands Waccamaw Orthopaedics and Spine
Practice address
4040 Highway 17
Suite 101
Murrells Inlet, SC 29576
Phone
(843) 652-8160
Fax
(843) 652-8161
NPI assigned
Jun 13, 2014
Last updated
May 1, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2020

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

Authorized official

Name
Elizabeth Sutherland Ward
Title
Evp & Cfo
Phone
(843) 527-7102

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X Primary

Addresses

Primary practice location

4040 Highway 17
Suite 101
Murrells Inlet, SC 29576

Mailing address

PO Box 421718
Georgetown, SC 29442-4203
Phone (843) 520-8883

Other identifiers 1

IdentifierTypeStateIssuer
GP6475MedicaidSC

Other names 1

  • Tidelands Waccamaw Orthopaedics and Spine Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL WWW.TIDELANDSHEALTH.ORG

National Provider Directory

National Provider Directory
Tax ID family
Georgetown Physician Associates16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1402617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588291200000",
    "number": "1851705206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421718",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294424203",
            "telephone_number": "843-520-8883",
            "fax_number": "843-652-8422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 HIGHWAY 17",
            "address_2": "SUITE 101",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "29576",
            "telephone_number": "843-652-8160",
            "fax_number": "843-652-8161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGETOWN PHYSICIAN ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-13",
        "last_updated": "2020-05-01",
        "certification_date": "2020-05-01",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "SUTHERLAND",
        "authorized_official_title_or_position": "EVP & CFO",
        "authorized_official_telephone_number": "843-527-7102"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP6475",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "WWW.TIDELANDSHEALTH.ORG",
            "affiliation": "N",
            "address_1": "4040 Highway 17",
            "address_2": "Suite 101",
            "city": "Murrells Inlet",
            "state": "SC",
            "country_code": "US",
            "postal_code": "29576",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Tidelands Waccamaw Orthopaedics and Spine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tidelands Waccamaw Orthopaedics and Spine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Murrells Inlet, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2020; 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.