NPIMap

Organization Active NPI

Georgetown Physician Associates LLC

Doing business as Tidelands Health Group

  • Family Medicine Physician
  • Georgetown, SC
National Provider Identifier
1881410587
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GEORGETOWN PHYSICIAN ASSOCIATES LLC
Doing business as
Tidelands Health Group
Practice address
606 Black River Rd Ste 300
Georgetown, SC 29440-3304
Phone
(843) 652-8290
Fax
(843) 546-8216
NPI assigned
Nov 26, 2024
Last updated
Jan 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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

Authorized official

Name
Erin Shaffer Beadle
Title
Chief Financial Officer (Cfo)/Evp
Phone
(843) 520-8617

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician 207PE0005X NU
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU
Hematology & Oncology Physician 207RH0003X NU
Obstetrics & Gynecology Physician 207V00000X NU
Orthopaedic Surgery Physician 207X00000X NU
Otolaryngology Physician 207Y00000X NU
Pediatrics Physician 208000000X NU
Neurology Physician 2084N0400X NU
Surgery Physician 208600000X NU
Urology Physician 208800000X NU

Addresses

Primary practice location

606 Black River Rd Ste 300
Georgetown, SC 29440-3304

Mailing address

PO Box 421718
Georgetown, SC 29442-4203

Other practice location 1

8203 Nigels Dr
Myrtle Beach, SC 29572-4177
Phone (843) 651-3308

Other practice location 2

9653 Ocean Hwy
Pawleys Island, SC 29585-7425
Phone (843) 235-3131

Other practice location 3

9699 Ocean Hwy
Pawleys Island, SC 29585-7425
Phone (843) 237-4296

Other practice location 4

2200 Crow Ln Ste 203
Myrtle Beach, SC 29577-1663
Phone (843) 848-5200

Other practice location 5

4367 Riverwood Dr Unit 140
Murrells Inlet, SC 29576-4381
Phone (843) 652-8020

Other practice location 6

4367 Riverwood Dr Unit 110
Murrells Inlet, SC 29576-4381
Phone (843) 652-8046

Other practice location 7

4367 Riverwood Dr Unit 100
Murrells Inlet, SC 29576-4381
Phone (843) 848-5350

Other practice location 8

4320 Holmestown Rd
Myrtle Beach, SC 29588-7837
Phone (843) 652-8440

Other practice location 9

4301 Dick Pond Rd
Myrtle Beach, SC 29588-6807
Phone (843) 652-8440

Other practice location 10

4181 Highway 17
Murrells Inlet, SC 29576-5019
Phone (843) 651-3308

Other practice location 11

701 S Morgan Ave
Andrews, SC 29510-2959
Phone (843) 264-5253

Other practice location 12

64 Business Center Dr
Pawleys Island, SC 29585-7963
Phone (843) 314-1314

Other practice location 13

606 Black River Rd Ste 301
Georgetown, SC 29440-3304
Phone (843) 652-8475

Other practice location 14

606 Black River Rd Ste 100
Georgetown, SC 29440-3304
Phone (843) 527-1800

Other practice location 15

606 Black River Rd
Georgetown, SC 29440-3304
Phone (843) 520-8020

Other practice location 16

1011 N Fraser St
Georgetown, SC 29440-2848
Phone (843) 527-3428

Other practice location 17

1014 Huger Dr
Georgetown, SC 29440-3322
Phone (843) 235-3131

Other practice location 18

1075 N Fraser St
Georgetown, SC 29440-2848
Phone (843) 527-4442

Other practice location 19

11916 Highway 707 Ste D
Murrells Inlet, SC 29576-9610
Phone (843) 652-8450

Other practice location 20

1220 21st Ave N
Myrtle Beach, SC 29577-7401
Phone (843) 652-8300

Other practice location 21

2200 Crow Ln
Myrtle Beach, SC 29577-1663
Phone (843) 652-8390

Other practice location 22

2200 Crow Ln Ste 201
Myrtle Beach, SC 29577-1663
Phone (843) 848-5001

Other practice location 23

2200 Crow Ln Ste 202
Myrtle Beach, SC 29577-1663
Phone (843) 545-5927

Other practice location 24

456 N Main St
Hemingway, SC 29554-9190
Phone (843) 558-9319

Other practice location 25

2200 Crow Ln Ste 301
Myrtle Beach, SC 29577-1663
Phone (843) 848-5350

Other practice location 26

2200 Crow Ln Ste 302
Myrtle Beach, SC 29577-1663
Phone (843) 848-5320

Other practice location 27

2200 Crow Ln Ste 303A
Myrtle Beach, SC 29577-1663
Phone (843) 848-5310

Other practice location 28

2200 Crow Ln Ste 303B
Myrtle Beach, SC 29577-1663
Phone (843) 520-8780

Other practice location 29

2200 Crow Ln Ste 303C
Myrtle Beach, SC 29577-1663
Phone (843) 652-8475

Other practice location 30

2347 S Highway 17
Murrells Inlet, SC 29576-7611
Phone (843) 357-2443

Other practice location 31

2405 N Fraser St
Georgetown, SC 29440-7764
Phone (843) 651-3308

Other practice location 32

3515 Caduceus Dr Ste B
Myrtle Beach, SC 29588-2922
Phone (843) 651-5689

Other practice location 33

3515 Caduceus Dr Ste D
Myrtle Beach, SC 29588-2922
Phone (843) 651-5689

Other practice location 34

4017 Highway 17 Ste 100
Murrells Inlet, SC 29576-5032
Phone (843) 651-6525

Other practice location 35

4040 Highway 17 Unit 101 & 105
Murrells Inlet, SC 29576
Phone (843) 652-8160

Other practice location 36

4040 Highway 17 Unit 104
Murrells Inlet, SC 29576-5098
Phone (843) 652-8390

Other practice location 37

4040 Highway 17 Unit 105
Murrells Inlet, SC 29576-5098
Phone (843) 652-8390

Other practice location 38

4040 Highway 17 Unit 202
Murrells Inlet, SC 29576-5098
Phone (843) 235-3131

Other practice location 39

4040 Highway 17 Unit 205
Murrells Inlet, SC 29576-5098
Phone (843) 652-8120

Other practice location 40

4040 Highway 17 Unit 206
Murrells Inlet, SC 29576-5098
Phone (843) 652-8260

Other practice location 41

4040 Highway 17 Unit 301
Murrells Inlet, SC 29576-5098
Phone (843) 652-8205

Other practice location 42

4040 Highway 17 Unit 302
Murrells Inlet, SC 29576-5098
Phone (843) 652-8290

Other practice location 43

4040 Highway 17 Unit 205
Murrells Inlet, SC 29576-5098
Phone (843) 652-8475

Other names 1

  • Tidelands Health Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130225000067 SC Part B Supplier - Clinic/Group Practice 2365697398 Receives reassigned benefits from 302 practitioners
30 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Murrells Inlet, SC; Myrtle Beach, SC; Pawleys Island, SC; Andrews, SC; Georgetown, SC; Hemingway, SC

Other NPIs on the same Medicare enrollment 30

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 30

National Provider Directory

National Provider Directory
Tax ID family
Georgetown Physician Associates LLC16 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

Locations

606 Black River Rd
Ste 301
Georgetown, SC 29440
Phone (843) 527-3428

2347 S Highway 17
Murrells Inlet, SC 29576
Phone (843) 357-2443

4017 Highway 17
Ste 100
Murrells Inlet, SC 29576
Phone (843) 651-6525

4040 Highway 17
Unit 105
Murrells Inlet, SC 29576
Phone (843) 652-8160

4040 Highway 17
Unit 302
Murrells Inlet, SC 29576
Phone (843) 652-8290

4367 Riverwood Dr
Unit 100
Murrells Inlet, SC 29576
Phone (843) 527-7139

4367 Riverwood Dr
Unit 104
Murrells Inlet, SC 29576
Phone (843) 652-8020

4367 Riverwood Dr
Unit 140
Murrells Inlet, SC 29576
Phone (843) 357-3162

4040 Highway 17
Unit 206
Murrells Inlt, SC 29576
Phone (843) 652-1100

4070 Highway 17
Murrells Inlt, SC 29576
Phone (843) 357-5100

1220 21st Ave N
Myrtle Beach, SC 29577
Phone (843) 652-8300

2200 Crow Ln
Ste 202
Myrtle Beach, SC 29577
Phone (843) 545-5927

2200 Crow Ln
Ste 203B
Myrtle Beach, SC 29577
Phone (843) 652-8475

2200 Crow Ln
Ste 302
Myrtle Beach, SC 29577
Phone (843) 848-5320

2200 Crow Ln
Ste 303A
Myrtle Beach, SC 29577
Phone (843) 848-5310

2200 Crow Ln
Ste 303C
Myrtle Beach, SC 29577
Phone (843) 652-8475

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

3515 Caduceus Dr
Ste C
Myrtle Beach, SC 29588
Phone (843) 527-1800

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

Practitioners & affiliated clinicians

Practitioners 299

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 299

NPI Registry JSON

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

{
    "created_epoch": "1732579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736726400000",
    "number": "1881410587",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 BLACK RIVER RD STE 300",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294403304",
            "telephone_number": "843-652-8290",
            "fax_number": "843-546-8216"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8203 Nigels Dr",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295724177",
            "country_code": "US",
            "telephone_number": "843-651-3308",
            "fax_number": "843-651-4629",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9653 Ocean Hwy",
            "address_purpose": "LOCATION",
            "city": "Pawleys Island",
            "state": "SC",
            "postal_code": "295857425",
            "country_code": "US",
            "telephone_number": "843-235-3131",
            "fax_number": "843-237-9797",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9699 Ocean Hwy",
            "address_purpose": "LOCATION",
            "city": "Pawleys Island",
            "state": "SC",
            "postal_code": "295857425",
            "country_code": "US",
            "telephone_number": "843-237-4296",
            "fax_number": "843-237-0495",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2200 Crow Ln Ste 203",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295771663",
            "country_code": "US",
            "telephone_number": "843-848-5200",
            "fax_number": "843-848-5001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4367 Riverwood Dr Unit 140",
            "address_purpose": "LOCATION",
            "city": "Murrells Inlet",
            "state": "SC",
            "postal_code": "295764381",
            "country_code": "US",
            "telephone_number": "843-652-8020",
            "fax_number": "843-652-8021",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4367 Riverwood Dr Unit 110",
            "address_purpose": "LOCATION",
            "city": "Murrells Inlet",
            "state": "SC",
            "postal_code": "295764381",
            "country_code": "US",
            "telephone_number": "843-652-8046",
            "fax_number": "843-357-9771",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4367 Riverwood Dr Unit 100",
            "address_purpose": "LOCATION",
            "city": "Murrells Inlet",
            "state": "SC",
            "postal_code": "295764381",
            "country_code": "US",
            "telephone_number": "843-848-5350",
            "fax_number": "843-520-8821",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4320 Holmestown Rd",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295887837",
            "country_code": "US",
            "telephone_number": "843-652-8440",
            "fax_number": "843-652-8441",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4301 Dick Pond Rd",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295886807",
            "country_code": "US",
            "telephone_number": "843-652-8440",
            "fax_number": "843-652-8441",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4181 Highway 17",
            "address_purpose": "LOCATION",
            "city": "Murrells Inlet",
            "state": "SC",
            "postal_code": "295765019",
            "country_code": "US",
            "telephone_number": "843-651-3308",
            "fax_number": "843-651-4629",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 S Morgan Ave",
            "address_purpose": "LOCATION",
            "city": "Andrews",
            "state": "SC",
            "postal_code": "295102959",
            "country_code": "US",
            "telephone_number": "843-264-5253",
            "fax_number": "843-264-5970",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "64 Business Center Dr",
            "address_purpose": "LOCATION",
            "city": "Pawleys Island",
            "state": "SC",
            "postal_code": "295857963",
            "country_code": "US",
            "telephone_number": "843-314-1314",
            "fax_number": "843-314-1308",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "606 Black River Rd Ste 301",
            "address_purpose": "LOCATION",
            "city": "Georgetown",
            "state": "SC",
            "postal_code": "294403304",
            "country_code": "US",
            "telephone_number": "843-652-8475",
            "fax_number": "843-652-8476",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "606 Black River Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Georgetown",
            "state": "SC",
            "postal_code": "294403304",
            "country_code": "US",
            "telephone_number": "843-527-1800",
            "fax_number": "843-527-6528",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "606 Black River Rd",
            "address_purpose": "LOCATION",
            "city": "Georgetown",
            "state": "SC",
            "postal_code": "294403304",
            "country_code": "US",
            "telephone_number": "843-520-8020",
            "fax_number": "843-652-8021",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1011 N Fraser St",
            "address_purpose": "LOCATION",
            "city": "Georgetown",
            "state": "SC",
            "postal_code": "294402848",
            "country_code": "US",
            "telephone_number": "843-527-3428",
            "fax_number": "843-436-0223",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1014 Huger Dr",
            "address_purpose": "LOCATION",
            "city": "Georgetown",
            "state": "SC",
            "postal_code": "294403322",
            "country_code": "US",
            "telephone_number": "843-235-3131",
            "fax_number": "843-237-9797",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1075 N Fraser St",
            "address_purpose": "LOCATION",
            "city": "Georgetown",
            "state": "SC",
            "postal_code": "294402848",
            "country_code": "US",
            "telephone_number": "843-527-4442",
            "fax_number": "843-527-4027",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11916 Highway 707 Ste D",
            "address_purpose": "LOCATION",
            "city": "Murrells Inlet",
            "state": "SC",
            "postal_code": "295769610",
            "country_code": "US",
            "telephone_number": "843-652-8450",
            "fax_number": "843-652-8451",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1220 21st Ave N",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295777401",
            "country_code": "US",
            "telephone_number": "843-652-8300",
            "fax_number": "843-652-8301",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2200 Crow Ln",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295771663",
            "country_code": "US",
            "telephone_number": "843-652-8390",
            "fax_number": "843-652-8399",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2200 Crow Ln Ste 201",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295771663",
            "country_code": "US",
            "telephone_number": "843-848-5001",
            "fax_number": "843-848-5225",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2200 Crow Ln Ste 202",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295771663",
            "country_code": "US",
            "telephone_number": "843-545-5927",
            "fax_number": "843-520-4780",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "456 N Main St",
            "address_purpose": "LOCATION",
            "city": "Hemingway",
            "state": "SC",
            "postal_code": "295549190",
            "country_code": "US",
            "telephone_number": "843-558-9319",
            "fax_number": "843-558-9818",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2200 Crow Ln Ste 301",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295771663",
            "country_code": "US",
            "telephone_number": "843-848-5350",
            "fax_number": "843-848-5355",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2200 Crow Ln Ste 302",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295771663",
            "country_code": "US",
            "telephone_number": "843-848-5320",
            "fax_number": "843-652-8299",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2200 Crow Ln Ste 303A",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295771663",
            "country_code": "US",
            "telephone_number": "843-848-5310",
            "fax_number": "843-237-9797",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2200 Crow Ln Ste 303B",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295771663",
            "country_code": "US",
            "telephone_number": "843-520-8780",
            "fax_number": "843-652-8399",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2200 Crow Ln Ste 303C",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295771663",
            "country_code": "US",
            "telephone_number": "843-652-8475",
            "fax_number": "843-652-8476",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2347 S Highway 17",
            "address_purpose": "LOCATION",
            "city": "Murrells Inlet",
            "state": "SC",
            "postal_code": "295767611",
            "country_code": "US",
            "telephone_number": "843-357-2443",
            "fax_number": "843-357-2132",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2405 N Fraser St",
            "address_purpose": "LOCATION",
            "city": "Georgetown",
            "state": "SC",
            "postal_code": "294407764",
            "country_code": "US",
            "telephone_number": "843-651-3308",
            "fax_number": "843-651-4629",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3515 Caduceus Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295882922",
            "country_code": "US",
            "telephone_number": "843-651-5689",
            "fax_number": "843-294-0062",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3515 Caduceus Dr Ste D",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295882922",
            "country_code": "US",
            "telephone_number": "843-651-5689",
            "fax_number": "843-294-0062",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4017 Highway 17 Ste 100",
            "address_purpose": "LOCATION",
            "city": "Murrells Inlet",
            "state": "SC",
            "postal_code": "295765032",
            "country_code": "US",
            "telephone_number": "843-651-6525",
            "fax_number": "843-357-0768",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4040 Highway 17 Unit 101 & 105",
            "address_purpose": "LOCATION",
            "city": "Murrells Inlet",
            "state": "SC",
            "postal_code": "29576",
            "country_code": "US",
            "telephone_number": "843-652-8160",
            "fax_number": "843-527-6528",
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        {
            "address_1": "4040 Highway 17 Unit 104",
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            "state": "SC",
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            "country_code": "US",
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        {
            "address_1": "4040 Highway 17 Unit 105",
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            "state": "SC",
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            "country_code": "US",
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            "fax_number": "843-652-8399",
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        {
            "address_1": "4040 Highway 17 Unit 202",
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            "state": "SC",
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            "address_1": "4040 Highway 17 Unit 205",
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            "state": "SC",
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            "country_code": "US",
            "telephone_number": "843-652-8120",
            "fax_number": "843-848-5355",
            "country_name": "United States",
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        {
            "address_1": "4040 Highway 17 Unit 206",
            "address_purpose": "LOCATION",
            "city": "Murrells Inlet",
            "state": "SC",
            "postal_code": "295765098",
            "country_code": "US",
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        {
            "address_1": "4040 Highway 17 Unit 301",
            "address_purpose": "LOCATION",
            "city": "Murrells Inlet",
            "state": "SC",
            "postal_code": "295765098",
            "country_code": "US",
            "telephone_number": "843-652-8205",
            "fax_number": "843-652-8215",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4040 Highway 17 Unit 302",
            "address_purpose": "LOCATION",
            "city": "Murrells Inlet",
            "state": "SC",
            "postal_code": "295765098",
            "country_code": "US",
            "telephone_number": "843-652-8290",
            "fax_number": "843-652-8299",
            "country_name": "United States",
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        {
            "address_1": "4040 Highway 17 Unit 205",
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            "state": "SC",
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            "fax_number": "843-652-8476",
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    ],
    "basic": {
        "organization_name": "GEORGETOWN PHYSICIAN ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-26",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A",
        "authorized_official_last_name": "SHAFFER BEADLE",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER (CFO)/EVP",
        "authorized_official_telephone_number": "843-520-8617"
    },
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            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
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        },
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            "code": "207R00000X",
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            "desc": "Internal Medicine",
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        },
        {
            "code": "207RH0003X",
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            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NU",
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        },
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            "desc": "Obstetrics & Gynecology",
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        },
        {
            "code": "207X00000X",
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            "desc": "Orthopaedic Surgery",
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        },
        {
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            "desc": "Otolaryngology",
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        },
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            "code": "208000000X",
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            "desc": "Pediatrics",
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        },
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            "code": "2084N0400X",
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            "desc": "Psychiatry & Neurology, Neurology",
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        },
        {
            "code": "208600000X",
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            "desc": "Surgery",
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        },
        {
            "code": "208800000X",
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            "desc": "Urology",
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            "license": null,
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    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tidelands Health Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tidelands Health Group",
            "code": "3",
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    ]
}

Other providers in Georgetown, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.