SOUTH CAROLINA PODIATRIC PHYSICIANS AND SURGEONS GROUP, LLC (NPI# 1659797140) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659797140 |
| Entity Type | Organization |
| Organization Name | SOUTH CAROLINA PODIATRIC PHYSICIANS AND SURGEONS GROUP, LLC |
| Practice Address |
8141 Rourk St Myrtle Beach SC 29572-4128 |
| Practice Telephone | 8434498079 |
| Practice Fax Number | 8434976147 |
| Mailing Telephone | 8434498079 |
| Mailing Fax Number | 8434976147 |
| Enumeration Date | 2014-03-09 |
| Last Update Date | 2014-03-09 |
| Authorized Official Name | BRANDON PERCIVAL (PRESIDENT) |
| Authorized Official Telephone | 8032851411 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
SC | Podiatric Medicine & Surgery Service Providers | |
| N | 213ES0131X |
Podiatrist Specialization: Foot Surgery |
SC | Podiatric Medicine & Surgery Service Providers | |
| Y | 213E00000X | Podiatrist | SC | Podiatric Medicine & Surgery Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922424423 | South Carolina Podiatric Physicians and Surgeons Group, LLC | Podiatrist | 166 Waccamaw Medical Park Ct, Conway, SC 29526-8965 | 2014-03-09 |
| 1144645722 | South Carolina Podiatric Physicians and Surgeons Group, LLC | Podiatrist | 1 Medical Park Dr Ste C, Chester, SC 29706-9769 | 2014-02-19 |
| 1699190272 | South Carolina Podiatric Physicians and Surgeons Group, LLC | Podiatrist | 9789 Charlotte Hwy Ste 200, Fort Mill, SC 29707-7182 | 2014-02-19 |
| 1578981452 | South Carolina Podiatric Physicians and Surgeons Group, LLC | Podiatrist | 3700 Sawtell Rd, Little River, SC 29566-7873 | 2014-03-28 |
| 1659797157 | South Carolina Podiatric Physicians and Surgeons Group, LLC | Podiatrist | 1120 Glenns Bay Rd, Suite 103, Surfside Beach, SC 29575-4757 | 2014-03-09 |
| 1477979979 | South Carolina Podiatric Physicians and Surgeons Group, LLC | Podiatrist | 3700 Sawtell Rd, Little River, SC 29566-7873 | 2014-03-09 |
| 1063837870 | South Carolina Podiatric Physicians and Surgeons Group, LLC | Podiatrist | 912 Inlet Square Dr, Murrells Inlet, SC 29576-7812 | 2014-03-03 |
| 1982029799 | South Carolina Podiatric Physicians and Surgeons Group, LLC | Podiatrist | 2845 E Highway 76, Medical Park 2 Ste 1, Mullins, SC 29574-6037 | 2014-03-03 |
| 1669897690 | South Carolina Podiatric Physicians and Surgeons Group, LLC | Podiatrist | 1575 E Main St, Duncan, SC 29334-9218 | 2014-02-27 |
| 1104241223 | South Carolina Podiatric Physicians and Surgeons Group, LLC | Podiatrist | 11 Mills Ave, Greenville, SC 29605-4015 | 2014-02-26 |
| Street Address |
8141 ROURK ST |
| City | MYRTLE BEACH |
| State | SC |
| Zip Code | 29572-4128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710948716 | Coastal Podiatry Associates Pa | Podiatrist | 8141 Rourk St, Myrtle Beach, SC 29572-4128 | 2006-03-29 |
| 1871849521 | Coastal Podiatry Associates, Pa | Non-Pharmacy Dispensing Site | 8141 Rourk St, Myrtle Beach, SC 29572-4128 | 2012-07-31 |
| 1780755652 | Joseph J Menn | Podiatrist | 8141 Rourk St, Myrtle Beach, SC 29572-4128 | 2006-11-13 |
| 1740351519 | Scott A Werter | Podiatrist | 8141 Rourk St, Myrtle Beach, SC 29572-4128 | 2006-11-13 |
| 1093886962 | Scott A Hamilton | Podiatrist | 8141 Rourk St, Myrtle Beach, SC 29572-4128 | 2006-11-13 |
| 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 | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053511253 | Corinne Marie Wisdo | Podiatrist | 907 Medical Cir, Myrtle Beach, SC 29572-4116 | 2007-07-25 |
| 1023006178 | Gery Brian Katalinich | Podiatrist | 5046 Hwy 17 Byp S, Suite 102, Myrtle Beach, SC 29588-4503 | 2005-10-12 |
| 1467628925 | Adam Tyler Biglin | Podiatrist | 907 Medical Cir, Myrtle Beach, SC 29572-4116 | 2008-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194331132 | Emad Youssef Dpm LLC | Podiatrist | 218 Granito Dr, Greer, SC 29650-2771 | 2020-09-16 |
| 1922618016 | Dr. Ashley Williams, LLC | Podiatrist | 3223 Hatchet Bay Dr Apt 7203, Charleston, SC 29414-5219 | 2020-08-04 |
| 1700424769 | Instride Foot & Ankle Specialists, Pllc | Podiatrist | 223 Herlong Ave S Ste 115, Rock Hill, SC 29732-1089 | 2019-12-20 |
| 1871011387 | Honored To Serve | Podiatrist | 1850 Atlantic Dr Unit 712, Columbia, SC 29210-7992 | 2017-09-05 |
| 1467989632 | Frederick Garland | Podiatrist | 767 Wintercreeper Dr, Longs, SC 29568-9229 | 2017-05-17 |
| 1245764430 | Aiken Podiatry Center | Podiatrist | 148 Waterloo St Sw Ste 4, Aiken, SC 29801-3766 | 2017-04-14 |
| 1982052031 | Harold Eugene Cook Iv | Podiatrist | 1730 St Julian Place, Columbia, SC 29204 | 2016-05-31 |
| 1669859104 | Mobile Podiatry South Carolina | Podiatrist | 10 Summerlea Ln, Columbia, SC 29203-3915 | 2015-05-05 |
| 1063829471 | Heather Driessen, Dpm, LLC | Podiatrist | 4072 Corner Stroll Ln, Aiken, SC 29801-1158 | 2014-07-17 |
| 1164855227 | Coastal Medical Services LLC | Podiatrist | 616 Churchill Rd, Walterboro, SC 29488-3622 | 2013-08-13 |
| Find all providers with the same taxonomy | ||||
| City | MYRTLE BEACH |
| Zip Code | 29572 |
Please comment or provide details below to improve the information on SOUTH CAROLINA PODIATRIC PHYSICIANS AND SURGEONS GROUP, LLC.
| 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.