MR. MATTHEW JANOWICZ (NPI# 1558735878) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558735878 |
| Entity Type | Individual |
| Full Name | MR. MATTHEW JANOWICZ |
| Practice Address |
5046 Highway 17 Byp S Ste 103 Myrtle Beach SC 29588-4503 |
| Mailing Address |
35 Green Pond Rd Ste C Rockaway NJ 07866-2057 |
| Practice Telephone | 8436684104 |
| Practice Fax Number | 8436684108 |
| Mailing Telephone | 9736250600 |
| Mailing Fax Number | 9736253434 |
| Enumeration Date | 2015-11-24 |
| Last Update Date | 2018-10-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 3046 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | PA5586 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
5046 HIGHWAY 17 BYP S STE 103 |
| City | MYRTLE BEACH |
| State | SC |
| Zip Code | 29588-4503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750553152 | Daniella Deperi | Physician Assistant | 5046 Highway 17 Byp S Ste 103, Myrtle Beach, SC 29588-4503 | 2008-03-26 |
| 1942700091 | Ashley G Parker | Nurse Practitioner | 5046 Highway 17 Byp S Ste 103, Myrtle Beach, SC 29588-4503 | 2018-02-15 |
| 1093068538 | Elizabeth M Duffy | Physician Assistant | 5046 Highway 17 Byp S Ste 103, Myrtle Beach, SC 29588 | 2012-10-22 |
| 1215223326 | Michael Robert Centilli | Dermatology | 5046 Highway 17 Byp S Ste 103, Myrtle Beach, SC 29588-4503 | 2011-06-27 |
| 1538460506 | Christopher Francis Buthorn | Physician Assistant | 5046 Highway 17 Byp S Ste 103, Myrtle Beach, SC 29588 | 2010-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740819309 | Forrest Halsey Westley | Pharmacist | 3072 Dick Pond Rd. Suite 2, Myrtle Beach, SC 29588 | 2020-04-06 |
| 1588124176 | The Counseling Center of Sayebrook | Counselor | 106 Lansford Court Suite 202, Myrtle Beach, SC 29588 | 2019-03-21 |
| 1134631443 | Solid Foundations, LLC | Clinic/Center | 4325 Dick Pond Road, Suite E, Myrtle Beach, SC 29588 | 2017-10-26 |
| 1316496037 | Grand Strand Rehab and Nursing Center, LLC | Skilled Nursing Facility | 4452 Socastee Boulevard, Myrtle Beach, SC 29588 | 2016-09-22 |
| 1386092039 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 1370 South Commons Drive, Suite 102, Myrtle Beach, SC 29588 | 2016-06-02 |
| 1114314531 | Allison Smith | Physical Therapy Assistant | 4870 Socastee Blvd, Myrtle Beach, SC 29588 | 2015-04-23 |
| 1760806160 | Myrtle Beach Physical Medicine & Rehab, LLC | Family Medicine | 4736 17 Bypass South, Myrtle Beach, SC 29588 | 2014-02-06 |
| 1801228499 | Robin Ruth Gause | Lactation Consultant, Non-RN | 510 Fairwood Lakes Ave, 14-c, Myrtle Beach, SC 29588 | 2013-08-06 |
| 1124386438 | Horace Earl Ferguson Jr. | Technician/Technologist | 4535 Dick Pond Road, A, Myrtle Beach, SC 29588 | 2012-04-25 |
| 1831463652 | Medeyecare, LLC | Technician/Technologist | 4335 Socastee Blvd, Unit A, Myrtle Beach, SC 29588 | 2012-02-24 |
| Find all providers in zip 29588 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053910596 | Sarah Xiao Jing Jarema | Physician Assistant | 1211 Hadley Cir Unit 4301, Myrtle Beach, SC 29577-8219 | 2020-10-24 |
| 1750553152 | Daniella Deperi | Physician Assistant | 5046 Highway 17 Byp S Ste 103, Myrtle Beach, SC 29588-4503 | 2008-03-26 |
| 1831204676 | Mercedes Zimmerman Davis | Physician Assistant | 106 Lansford Pl, Myrtle Beach, SC 29588-6979 | 2006-08-20 |
| 1033181193 | Tracy Reymore Black | Physician Assistant | 8208 Devon Court, Suite B, Myrtle Beach, SC 29572 | 2006-02-03 |
| 1619969250 | Randall Paul Grove | Physician Assistant | 1101 Johnson Ave, Myrtle Beach, SC 29577-1893 | 2005-08-19 |
| 1487655106 | Ashley Smith Wilson | Physician Assistant | 945 82nd Parkway, Myrtle Beach, SC 29572 | 2005-08-03 |
| 1487294179 | Jimmy Gregory Stevens | Physician Assistant | 920 Doug White Dr Ste 130, Myrtle Beach, SC 29572-4120 | 2020-01-09 |
| 1225686835 | Kaycee Lauren Villane | Physician Assistant | 920 Doug White Dr Ste 130, Myrtle Beach, SC 29572-4120 | 2019-08-27 |
| 1477100766 | Sarah Snyder Brown | Physician Assistant | 809 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2019-08-21 |
| 1619523412 | Strand Physician Specialists, Pa | Physician Assistant | 945 82nd Pkwy, Myrtle Beach, SC 29572-4612 | 2019-08-16 |
| Find all providers in MYRTLE BEACH | ||||
| City | MYRTLE BEACH |
| Zip Code | 29588 |
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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.