NPIMap

Organization Active NPI

Angelic Health of SC LLC

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Myrtle Beach, SC
National Provider Identifier
1962075580
Registry record updated Jul 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
Legal business name
ANGELIC HEALTH OF SC LLC
Practice address
923 Medical Cir
Myrtle Beach, SC 29572-4116
Phone
(854) 444-9998
NPI assigned
Jul 21, 2021
Organization subpart
Yes
Parent organization
ANGELIC HEALTH OF SC LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2021

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

Authorized official

Name
Dan Mikus
Title
Ceo
Phone
(609) 822-7979

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RH0002X Primary

Addresses

Primary practice location

923 Medical Cir
Myrtle Beach, SC 29572-4116

Mailing address

8025 Black Horse Pike Ste 501
Pleasantville, NJ 08232-2967
Phone (609) 822-7979

Other names 1

  • Angelic Palliative Care Other name

National Provider Directory

National Provider Directory
Tax ID family
Angelic Health of SC LLC2 organizations share this tax ID, including this one
Part of
Angelic Health of SC LLC

Other organizations with this tax ID 1

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1626825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626825600000",
    "number": "1962075580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8025 BLACK HORSE PIKE STE 501",
            "city": "PLEASANTVILLE",
            "state": "NJ",
            "postal_code": "082322967",
            "telephone_number": "609-822-7979",
            "fax_number": "609-822-7980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "923 MEDICAL CIR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724116",
            "telephone_number": "854-444-9998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGELIC HEALTH OF SC LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ANGELIC HEALTH OF SC LLC",
        "enumeration_date": "2021-07-21",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A",
        "authorized_official_last_name": "MIKUS",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "609-822-7979"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Angelic Palliative Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jul 21, 2021; 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.