GOATEE VASCULAR LLC (NPI# 1962765081) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962765081 |
| Entity Type | Organization |
| Organization Name | GOATEE VASCULAR LLC |
| Practice Address |
4036 River Oaks Dr Unit B2 Myrtle Beach SC 29579-6695 |
| Mailing Address |
1415 Eastridge Rd Richmond VA 23229-5501 |
| Practice Telephone | 7573332066 |
| Practice Fax Number | 7574672703 |
| Mailing Telephone | 7573332066 |
| Mailing Fax Number | 7574672703 |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2012-06-22 |
| Authorized Official Name | MS. ANGELA N SCHWARZKOPF (ADMINISTRATOR) |
| Authorized Official Telephone | 7573332066 |
| Authorized Official Credential | CPC, CMPE, MBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
SC | Allopathic & Osteopathic Physicians |
| Street Address |
4036 RIVER OAKS DR UNIT B2 |
| City | MYRTLE BEACH |
| State | SC |
| Zip Code | 29579-6695 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407252307 | Optic Gallery, LLC | Optometrist | 4036 River Oaks Dr, Suite B-8, Myrtle Beach, SC 29579-6695 | 2014-11-05 |
| 1407102429 | Midatlantic Vascular, LLC | Clinic/Center | 4036 River Oaks Dr, Unit B2, Myrtle Beach, SC 29579-6695 | 2012-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598323198 | P & E Company | Counselor | 4105 Carolina Commercial Dr. Unit #2, Myrtle Beach, SC 29579 | 2019-05-30 |
| 1528624632 | Matthew Meehan | Nurse Practitioner | 4016 River Oaks Dr # 6511, Myrtle Beach, SC 29579 | 2019-05-14 |
| 1427518265 | Brian Donovan Doherty | Student in an Organized Health Care Education/Training Program | Grand Strand Medical Center 809 82nd Parkway, Gme Office, Myrtle Beach, SC 29579 | 2019-03-20 |
| 1508347931 | South Carolina Cvs Pharmacy LLC | Pharmacy | 578 International Dr, Myrtle Beach, SC 29579 | 2018-08-23 |
| 1497256176 | Orthosc LLC | Orthopaedic Surgery | 185 Fresh Dr Ste B, Myrtle Beach, SC 29579 | 2018-02-27 |
| 1740708981 | Dental Professional of South Carolina, P.C. | Dentist | 568 International Dr, Myrtle Beach, SC 29579 | 2017-09-08 |
| 1093232480 | Johnathan T Steppe | Dentist | 568 International Drive, Myrtle Beach, SC 29579 | 2017-08-25 |
| 1346638483 | Little River Medical Center, Inc | Clinic/Center | 4220 Carolina Exchange Blvd, Myrtle Beach, SC 29579 | 2014-12-23 |
| 1154726818 | Mina Gaid | Pharmacist | 1303 38th Avenue North, Myrtle Beach, SC 29579 | 2014-10-23 |
| 1528471364 | Paola Goyeneche | Counselor | 5015 Carolina Forest Blvd, Myrtle Beach, SC 29579 | 2014-06-10 |
| Find all providers in zip 29579 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740840024 | Tyler Buckley | Surgery | 169 Ashley Ave, Room 202 Main Hospital, Msc333, Charleston, SC 29425 | 2019-06-18 |
| 1043766017 | Charleston Vascular Surgery, P.C. | Surgery | 1280 Hospital Drive, Suite 302, Charleston Vascular Surgery, P.C., Mount Pleasant, SC 29464-1901 | 2016-08-30 |
| 1104237338 | William Jackson | Surgery | 101 S Ravenel St Ste 230, Florence, SC 29506-2624 | 2014-05-09 |
| 1518149350 | Thomas Russell Wieters, M.d., P.a. | Surgery | 3070 Highway 17 N, Suite 202, Mount Pleasant, SC 29466-9300 | 2007-12-04 |
| 1801985007 | Thomas C. Appleby | Surgery | 1327 Ashley River Road, Building B, Charleston, SC 29407 | 2006-10-12 |
| 1962519546 | Mary Black Health System LLC | Surgery | 1690 Skylyn Dr Ste 350, Spartanburg, SC 29307-1039 | 2006-08-23 |
| 1164536215 | Sean J Hislop | Surgery | 1327 Ashley River Rd, Charleston, SC 29407-5384 | 2006-08-18 |
| 1881600963 | Louis F Knoepp IIi | Surgery | 100 Health Way, Suite 1240, Anderson, SC 29621-7917 | 2006-07-31 |
| 1659321115 | Robert C. Allen | Surgery | 197 Piedmont Blvd Ste 100, Rock Hill, SC 29732-1824 | 2006-05-12 |
| 1164496527 | The Regional Medical Center of Orangeburg and Calhoun Counties | Surgery | 1175 Cook Rd Ste 320, Orangeburg, SC 29118-8247 | 2006-02-14 |
| Find all providers with the same taxonomy | ||||
| City | MYRTLE BEACH |
| Zip Code | 29579 |
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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.