ALEXANDER PETKOVSEK (NPI# 1013455302) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013455302 |
| Entity Type | Individual |
| Full Name | ALEXANDER PETKOVSEK |
| Practice Address |
920 Doug White Dr Ste 210 Myrtle Beach SC 29572-4120 |
| Practice Telephone | 8434976348 |
| Practice Fax Number | 8434976351 |
| Mailing Telephone | 8434976348 |
| Mailing Fax Number | 8434976351 |
| Enumeration Date | 2017-02-07 |
| Last Update Date | 2020-02-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
20710 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 12 | 05 |
| Street Address |
920 DOUG WHITE DR STE 210 |
| City | MYRTLE BEACH |
| State | SC |
| Zip Code | 29572-4120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407826308 | Christoph R Kaufmann | Surgery | 920 Doug White Dr Ste 210, Myrtle Beach, SC 29572-4120 | 2006-01-24 |
| 1881235877 | Ashley Brooke Alley | Nurse Practitioner | 920 Doug White Dr Ste 210, Myrtle Beach, SC 29572-4120 | 2019-10-01 |
| 1588174635 | Jacqueline Susanne Crowell | Nurse Practitioner | 920 Doug White Dr Ste 210, Myrtle Beach, SC 29572-4120 | 2017-10-03 |
| 1851823744 | Katherine Ventura | Physician Assistant | 920 Doug White Dr Ste 210, Myrtle Beach, SC 29572-4120 | 2017-03-30 |
| 1184073843 | Daniel Brown | Physician Assistant | 920 Doug White Dr Ste 210, Myrtle Beach, SC 29572-4120 | 2016-06-03 |
| 1023482957 | La'asha Burgess | Physician Assistant | 920 Doug White Dr Ste 210, Myrtle Beach, SC 29572-4120 | 2015-11-16 |
| 1477943744 | Michael Cruse | Nurse Practitioner | 920 Doug White Dr Ste 210, Myrtle Beach, SC 29572-4120 | 2015-01-26 |
| 1609122910 | Samuel Dean Baughman Jr. | Surgery | 920 Doug White Dr Ste 210, Myrtle Beach, SC 29572-4120 | 2012-07-24 |
| 1972862142 | Rachel Cobos | Surgery | 920 Doug White Dr Ste 210, Myrtle Beach, SC 29572-4120 | 2012-05-09 |
| 1023270287 | Allison Lundy Mccrae | Surgery | 920 Doug White Dr Ste 210, Myrtle Beach, SC 29572-4120 | 2008-06-30 |
| Find all providers in the same location | ||||
| 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 | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225671027 | Tara Sharay Woods | Nurse Practitioner | 215 Ronnie Ct Ste D, Myrtle Beach, SC 29579-4204 | 2019-10-24 |
| 1629611694 | Nancy Lauren Johnson | Nurse Practitioner | 101 Mcleod Health Blvd, Myrtle Beach, SC 29579-4477 | 2019-10-23 |
| 1528624632 | Matthew Meehan | Nurse Practitioner | 4016 River Oaks Dr # 6511, Myrtle Beach, SC 29579 | 2019-05-14 |
| 1528569712 | Sarah Manglicmot Campos | Nurse Practitioner | 2050 Corporate Centre Dr Ste 220, Myrtle Beach, SC 29577-7428 | 2018-02-23 |
| 1679088793 | Maribeth Reid | Nurse Practitioner | 3236 Holmestown Rd Unit E1, Myrtle Beach, SC 29588-7495 | 2017-12-12 |
| 1184165714 | Emily Whitehurst | Nurse Practitioner | 3913 Carnegie Ave, Apt 216, Myrtle Beach, SC 29588-1144 | 2017-03-15 |
| 1851835441 | Sandra Graham | Nurse Practitioner | 101 Mcleod Health Blvd Ste 202, Myrtle Beach, SC 29579-4477 | 2016-12-15 |
| 1487058434 | Ashley Adams | Nurse Practitioner | 4887 Socastee Blvd, Myrtle Beach, SC 29588-7245 | 2014-10-20 |
| 1699191262 | Tiffany Mahaffey | Nurse Practitioner | 1101 Brightwater Drive, Agape Physicians Care, Myrtle Beach, SC 29579 | 2014-03-06 |
| 1902235864 | Larissa Connell | Nurse Practitioner | 2510 N Kings Hwy, Myrtle Beach, SC 29577-3037 | 2013-11-01 |
| Find all providers in MYRTLE BEACH | ||||
| City | MYRTLE BEACH |
| Zip Code | 29572 |
Please comment or provide details below to improve the information on ALEXANDER PETKOVSEK.
| 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.