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

Last updated

Sep 5, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

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

Title

Owner

Phone

(843) 236-9090

Specialties & licenses 3

Addresses

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

Practitioners 7

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.

• Michael P Gambacorta, FNP

  • Nurse Practitioner
  • Myrtle Beach, SC
  • NPI 1851393920

  Chiropractor

  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)

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

{
    "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

• Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• 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.