Myrtle Beach Spine Center, PA

Primary specialty

Neuromuscular Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081N0008X

Legal business name

MYRTLE BEACH SPINE CENTER, PA

Practice address

100 Legends Rd Suite a
Myrtle Beach, SC 29579-7076

Phone

(843) 236-9090

Fax

(843) 236-9099

NPI assigned

Jun 13, 2012

Organization subpart

No

Name

Dr. Michael P Gambacorta, DC, FNP-BCNPI 1851393920

Title

Owner

Phone

(843) 236-9090

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael P Gambacorta, FNP

  • Nurse Practitioner
  • Myrtle Beach, SC
  • NPI 1851393920

  Chiropractor, SC

  Medicare reassignment NPD Authorized official
• Patricia Ann Dodd, D.C.

  • Chiropractor
  • Kinston, NC
  • NPI 1093045783
  NPD (past)
• Ashley Clinton Owens, D.C.

  • Chiropractor
  • Raleigh, NC
  • NPI 1164753422
  NPD (past)
• Joshua Wayne Race, D.C.

  • Chiropractor
  • Morehead City, NC
  • NPI 1801055496
  NPD (past)
• Benjamin Forrest Rhoades, D.C.

  • Chiropractor
  • Huntersville, NC
  • NPI 1982978730
  NPD (past)
• Chad Risoldi, D.C.

  • Chiropractor
  • Huntersville, NC
  • NPI 1942671326
  NPD (past)
• David Peter Warchal Jr.

  • Student in an Organized Health Care Education/Training Program
  • Depew, NY
  • NPI 1699007005
  NPD (past)

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Interoperability endpoints

• Direct secure messaging: michael@mbsc0002.direct.chirotouch.md
• Direct secure messaging: torri@mbsc0002.direct.chirotouch.md

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 5, 2024.

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725494400000",
    "number": "1962764142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 LEGENDS RD STE A",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295797076",
            "telephone_number": "919-394-3225",
            "fax_number": "843-236-9099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 LEGENDS RD SUITE A",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295797076",
            "telephone_number": "843-236-9090",
            "fax_number": "843-236-9099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYRTLE BEACH SPINE CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-13",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A",
        "authorized_official_last_name": "GAMBACORTA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-236-9090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC, FNP-BC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081N0008X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Neuromuscular Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Myrtle Beach Family Medicine, PA
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• Myrtle Beach Plastic Surgery Specialistts,LLC
• Myrtle Beach Smiles Youth Dentistry, LLC
• Myrtle Beach Treatment Specialists LLC
• Myrtle Point Inpatient Services LLC
• Shashikanth Nagabandi, M.D.
• Charles Robert Nagel Jr.
• Naren Srinath Nallapeta, MD

• All providers in Myrtle Beach, SC
• Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; 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.