LITTLE RIVER MEDICAL CENTER, INC. (NPI# 1184783284) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184783284 |
| Entity Type | Organization |
| Organization Name | LITTLE RIVER MEDICAL CENTER, INC. |
| Practice Address |
7724 N Kings Hwy Myrtle Beach SC 29572-3041 |
| Mailing Address |
Po Box 547 Little River SC 29566-0547 |
| Practice Telephone | 8438393939 |
| Practice Fax Number | 8438393946 |
| Mailing Telephone | 8436631013 |
| Mailing Fax Number | 8436631017 |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2014-12-09 |
| Authorized Official Name | MRS. AVANGELA KAY CRISWELL (BUSINESS OFFICE DIRECTOR) |
| Authorized Official Telephone | 8436631013 |
| Is Organization Subpart | Y |
| Parent Organization Name | LITTLE RIVER MEDICAL CENTER, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 122300000X | Dentist | SC | Dental Providers | |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
SC | Behavioral Health & Social Service Providers | |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
SC | Physician Assistants & Advanced Practice Nursing Providers | |
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | ZA9656 | 05 | |
| SC | FQC065 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932457751 | Little River Medical Center, Inc. | Clinic/Center | 700 Augusta Plantation Drive, Myrtle Beach, SC 29579-6713 | 2012-08-28 |
| 1225304546 | Little River Medical Center, Inc. | Counselor | 1411 10th Ave N, Myrtle Beach, SC 29577-5615 | 2012-03-30 |
| 1528333952 | Little River Medical Center, Inc. | Dentist | 504 Church St, Conway, SC 29526-4822 | 2012-03-19 |
| 1437455144 | Little River Medical Center, Inc. | Social Worker | 7726 N Kings Hwy, Myrtle Beach, SC 29572-3041 | 2011-01-28 |
| 1841514262 | Little River Medical Center, Inc. | Dentist | 3001 4th Ave, Conway, SC 29527-5914 | 2010-03-15 |
| 1679897094 | Little River Medical Center, Inc. | Dentist | 620 29th Ave N, Myrtle Beach, SC 29577-3169 | 2010-03-15 |
| 1942524368 | Little River Medical Center, Inc. | Dentist | 5209 Highway 66, Loris, SC 29569-5962 | 2010-03-15 |
| 1437473857 | Little River Medical Center, Inc. | Dentist | 1101 Snowhill Dr, Conway, SC 29526-3665 | 2010-03-15 |
| 1851615272 | Little River Medical Center, Inc. | Dentist | 3011 Nichols Hwy, Galivants Ferry, SC 29544-6059 | 2010-03-15 |
| 1770807190 | Little River Medical Center, Inc. | Dentist | 4580 Highway 472, Conway, SC 29526-6340 | 2010-03-15 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | LITTLE RIVER MEDICAL CENTER, INC. | 451 W Locke St, Ashdown, AR 71822-3325 |
| Street Address |
7724 N KINGS HWY |
| City | MYRTLE BEACH |
| State | SC |
| Zip Code | 29572-3041 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700837853 | Thomas F. Garland | Family Medicine | 7724 N Kings Hwy, Myrtle Beach, SC 29572-3041 | 2006-05-13 |
| 1346641131 | Dawn Marie Coffin | Nurse Practitioner | 7724 N Kings Hwy, Myrtle Beach, SC 29572-3041 | 2014-09-11 |
| 1740444645 | Bennie L Smith | Dentist | 7724 N Kings Hwy, Myrtle Beach, SC 29572-3041 | 2008-07-10 |
| 1003035965 | Wilma J Spencer | Nurse Practitioner | 7724 N Kings Hwy, Myrtle Beach, SC 29572-3041 | 2007-04-25 |
| 1063429645 | Deborah Ann Klick | Social Worker | 7724 N Kings Hwy, Myrtle Beach, SC 29572-3041 | 2006-08-03 |
| 1194778423 | Paul S Cohen | Internal Medicine | 7724 N Kings Hwy, Myrtle Beach, SC 29572-3041 | 2006-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629684576 | Matthew David Zeuschner | Nurse Practitioner | 107 Woodwind Court, Myrtle Beach, SC 29572 | 2020-09-16 |
| 1578191789 | Julia Ruth Nelson | Student in an Organized Health Care Education/Training Program | Grand Strand Medical Center- Gme Office, 809 82nd Parkway, Myrtle Beach, SC 29572 | 2020-04-01 |
| 1407484835 | Justin Schevers | Student in an Organized Health Care Education/Training Program | 802 82nd Parkway, Myrtle Beach, SC 29572 | 2020-03-31 |
| 1922636919 | Darian Michael Quigg | Student in an Organized Health Care Education/Training Program | 809 82nd Street Parkway, Myrtle Beach, SC 29572 | 2020-03-27 |
| 1881221141 | Jonathan Alden Bryan | Student in an Organized Health Care Education/Training Program | Grand Strand Medical Center, 809 82nd Parkway, Myrtle Beach, SC 29572 | 2020-03-26 |
| 1215575238 | Polaris Skin Diagnostics, LLC | Dermatology | 8170 Rourk Street, Suite 100, Myrtle Beach, SC 29572 | 2019-12-20 |
| 1700348711 | Five Star Rehabilitation and Wellness Services, LLC. | Clinic/Center | 9547 N Kings Hwy, Myrtle Beach, SC 29572 | 2019-04-01 |
| 1154882975 | Michael Kouandjio | Student in an Organized Health Care Education/Training Program | Grand Strand Medical Center-gme Office, 809 82nd Parkway, Myrtle Beach, SC 29572 | 2019-03-26 |
| 1154880102 | Dylan Chase Morgan | Internal Medicine | Grand Strand Medical Center - Gme Office, 809 82nd Pkwy, Myrtle Beach, SC 29572 | 2019-03-19 |
| 1710446828 | David Redding Kingery Jr. | Student in an Organized Health Care Education/Training Program | Gme Office 809 82nd Parkway, Myrtle Beach, SC 29572 | 2019-03-18 |
| Find all providers in zip 29572 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346638483 | Little River Medical Center, Inc | Clinic/Center | 4220 Carolina Exchange Blvd, Myrtle Beach, SC 29579 | 2014-12-23 |
| 1932457751 | Little River Medical Center, Inc. | Clinic/Center | 700 Augusta Plantation Drive, Myrtle Beach, SC 29579-6713 | 2012-08-28 |
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| 1982248852 | Regenesis Organization Community Health Center | Clinic/Center | 115 Thomas St Ste B, Union, SC 29379-2147 | 2019-11-04 |
| 1720636012 | Genesis Health Care, Inc | Clinic/Center | 115 Exchange St, Darlington, SC 29532-3203 | 2019-08-29 |
| 1063079549 | Health Care Partners of South Carolina, Inc. | Clinic/Center | 243 Singleton Ridge Rd, Units E&f, Conway, SC 29526-8391 | 2019-05-21 |
| 1043775703 | Rural Health Services Inc | Clinic/Center | 4200 Whiskey Rd, Aiken, SC 29803-8534 | 2019-02-07 |
| 1295202356 | Eau Claire Cooperative Health Center Inc. | Clinic/Center | 2600 Wheat St, Columbia, SC 29205-2315 | 2018-10-26 |
| 1215410667 | Low Country Health Care System | Clinic/Center | 19340 Solomon Blatt Ave N, Blackville, SC 29817-2304 | 2018-09-12 |
| 1922584481 | Sandhills Medical Foundation, Inc. | Clinic/Center | 290 Market Street, Ruby, SC 29741 | 2018-07-17 |
| Find all providers with the same taxonomy | ||||
| City | MYRTLE BEACH |
| Zip Code | 29572 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.