NPIMap

Individual provider Active NPI

Derek Anthony Pride

  • Family Medicine Physician
  • Myrtle Beach, SC
National Provider Identifier
1952938847
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
83289 Issued in SC
Practice address
945 82ND Pkwy
Myrtle Beach, SC 29572-4612
Phone
(843) 497-5929
Fax
(866) 778-9608
NPI assigned
Mar 23, 2020
Last updated
Jul 28, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 83289 SC Primary

Addresses

Primary practice location

945 82ND Pkwy
Myrtle Beach, SC 29572-4612

Mailing address

PO Box 3439
North Myrtle Beach, SC 29582-0439
Phone (843) 839-4447

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230510001334 SC Practitioner - Family Practice 5991104606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Edward Via Col of Osteo Medicine-Carolinas Campus, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Strand Physician Specialists PAGroup PAC ID 1153226576, 56 clinicians

Practice addresses (Care Compare)

945 82ND Pkwy
Myrtle Beach, SC 29572-4612
Phone (843) 497-5929

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Strand Physician Specialists, PA Current Accepting new patients
Strand Physician Specialists, PA Family Medicine CurrentSince Jul 1, 2023 Accepting new patients
Strand Physician Specialists, PA Family Medicine CurrentSince Jul 1, 2023 Accepting new patients
Strand Physician Specialists, PA Past Accepting new patients

Locations

4591 Socastee Blvd
Myrtle Beach, SC 29588

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

945 82nd Pkwy
Myrtle Beach, SC 29572

Interoperability endpoints

  • Direct secure messaging: derek.pride.1@842.direct.athenahealth.com
  • Direct secure messaging: derek.pride@hca5.eclinicaldirectplus.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1584921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1952938847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3439",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295820439",
            "telephone_number": "843-839-4447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 82ND PKWY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724612",
            "telephone_number": "843-497-5929",
            "fax_number": "866-778-9608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIDE",
        "first_name": "DEREK",
        "middle_name": "ANTHONY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-23",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "83289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.