NPIMap

Organization Active NPI

Georgetown Physician Associates, LLC

Doing business as Tidelands Health orthopaedics

  • Orthopaedic Surgery Physician
  • Georgetown, SC
National Provider Identifier
1912401399
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 Health orthopaedics
Practice address
2185 N Fraser St
Georgetown, SC 29440
Phone
(843) 527-1800
Fax
(843) 527-6528
NPI assigned
Mar 21, 2018
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 NU Primary

Addresses

Primary practice location

2185 N Fraser St
Georgetown, SC 29440

Mailing address

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

Other practice location 1

3515 Caduceus Dr
Myrtle Beach, SC 29588-2922
Phone (843) 527-1800

Other identifiers 1

IdentifierTypeStateIssuer
C120OtherSCMEDICARE PTAN

Other names 1

  • Tidelands Health orthopaedics Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL www.tidelandshealth.org

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

2185 N Fraser St
Georgetown, SC 29440
Phone (843) 520-1941

3515 Caduceus Dr
Myrtle Beach, SC 29588
Phone (305) 793-0522

NPI Registry JSON

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

{
    "created_epoch": "1521590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588291200000",
    "number": "1912401399",
    "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": "2185 N FRASER ST",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "29440",
            "telephone_number": "843-527-1800",
            "fax_number": "843-527-6528"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3515 Caduceus Dr",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295882922",
            "country_code": "US",
            "telephone_number": "843-527-1800",
            "fax_number": "843-527-6528",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GEORGETOWN PHYSICIAN ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-21",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "C120",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.tidelandshealth.org",
            "affiliation": "N",
            "address_1": "2185 N Fraser St",
            "city": "Georgetown",
            "state": "SC",
            "country_code": "US",
            "postal_code": "29440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Tidelands Health orthopaedics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tidelands Health orthopaedics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 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.