VILLAGE FAMILY MEDICAL (NPI# 1033558002) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033558002 |
| Entity Type | Organization |
| Organization Name | VILLAGE FAMILY MEDICAL |
| Practice Address |
3012 Newcastle Loop Myrtle Beach SC 29588-4501 |
| Mailing Address |
3280 Plattmoor Dr Myrtle Beach SC 29588-7718 |
| Practice Telephone | 8434245565 |
| Mailing Telephone | 8434245565 |
| Enumeration Date | 2013-06-22 |
| Last Update Date | 2013-06-22 |
| Authorized Official Name | JAMES DAVID WOODCOCK (OWNER/OPERATOR) |
| Authorized Official Telephone | 8434245565 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
1977 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | INDIVIDUAL NPI | 1285650085 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063884088 | Village Family Medical | Internal Medicine | 1500 Route 517, Suite 108, Hackettstown, NJ 07840-2717 | 2015-10-29 |
| Street Address |
3012 NEWCASTLE LOOP |
| City | MYRTLE BEACH |
| State | SC |
| Zip Code | 29588-4501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871541896 | John Michael Rearden | Dentist | 3012 Newcastle Loop, Myrtle Beach, SC 29588 | 2006-05-04 |
| 1952583924 | Village Family Dental | Dentist | 3012 Newcastle Loop, Myrtle Beach, SC 29588-4501 | 2007-12-03 |
| 1316973357 | Stephen F Tuttle | Dentist | 3012 Newcastle Loop, Myrtle Beach, SC 29588-4501 | 2006-06-23 |
| 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 | 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 | 29588 |
Please comment or provide details below to improve the information on VILLAGE FAMILY MEDICAL.
| 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.