MR. BRADLEY CLAY HORNICK (NPI# 1053655530) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053655530 |
| Entity Type | Individual |
| Full Name | MR. BRADLEY CLAY HORNICK |
| Credential | C.P.O. |
| Practice Address |
931 Medical Cir Myrtle Beach SC 29572-4122 |
| Practice Telephone | 8438775224 |
| Mailing Telephone | 8438775224 |
| Enumeration Date | 2012-11-21 |
| Last Update Date | 2012-11-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 222Z00000X | Orthotist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 224P00000X | Prosthetist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
931 MEDICAL CIR |
| City | MYRTLE BEACH |
| State | SC |
| Zip Code | 29572-4122 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154665644 | Beachside Clinic Inc | Prosthetic/Orthotic Supplier | 931 Medical Cir, Myrtle Beach, SC 29572-4122 | 2012-11-21 |
| 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 | 224P00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Prosthetist |
| A health care professional who is specifically educated and trained to manage comprehensive prosthetic patient care for individuals who have sustained complete or partial limb loss or absence. Prosthetists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932723947 | Jonica D Richardson | Prosthetist | 417 Grand National Ln, Elgin, SC 29045-7113 | 2020-06-04 |
| 1700449964 | Nicole D Jennings | Prosthetist | 920 Saint Andrews Rd Ste 2&3, Columbia, SC 29210-5816 | 2019-04-15 |
| 1629588520 | Adrienne Jackson | Prosthetist | 2005 Old Laurens Rd, Greenwood, SC 29649 | 2017-10-05 |
| 1013465756 | Marquetta Breslin | Prosthetist | 125 Salt Meadow Ln, Summerville, SC 29483-5334 | 2016-09-12 |
| 1457721839 | Richard Goodman II | Prosthetist | 386 Rutt Ln, Goose Creek, SC 29445-7808 | 2015-09-29 |
| 1699153775 | Lisa Burks | Prosthetist | 4026 Ashley Phosphate Rd, Charleston, SC 29418-8547 | 2015-05-11 |
| 1548308695 | Alvin W. Pickering | Prosthetist | 230 Elliott St, Orangeburg, SC 29115-6022 | 2007-02-01 |
| 1114486529 | Clarissa Rose | Prosthetist | 950 W Faris Rd, Greenville, SC 29605-4255 | 2019-03-15 |
| 1275807174 | Brian Kaluf | Prosthetist | 10 Enterprise Blvd, Suite 206, Greenville, SC 29615-6301 | 2012-02-24 |
| City | MYRTLE BEACH |
| Zip Code | 29572 |
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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.