Dwayne Michael Beam, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

474 Issued in SC

Practice address

132 Chanticleer Drive West
Conway, SC 29526

Phone

(843) 349-2825

Fax

(843) 234-3451

NPI assigned

Sep 22, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972602266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3855 CAMDEN DR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295887858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 CHANTICLEER DRIVE WEST",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "29526",
            "telephone_number": "843-349-2825",
            "fax_number": "843-234-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAM",
        "first_name": "DWAYNE",
        "middle_name": "MICHAEL",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "SC",
            "license": "474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Baum
• Olivia Jayden Bauman
• Helen M Bayne, M.S.
• Henna Bazai
• Beach Medical Specialists PA
• Matthew John Beauchemin, BA, BS
• David M Beck, MD
• Twila Beckman, LPN
• Gretchen Lee Beebe, LPC, NCC
• Behavior Builders ABA LLC

• Athletic Trainer in Conway, SC
• Providers in Conway, SC by specialty
• Athletic Trainer in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.