CAPESIDE ADDICTION CARE, PLLC (NPI# 1093280620) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093280620 |
| Entity Type | Organization |
| Organization Name | CAPESIDE ADDICTION CARE, PLLC |
| Practice Address |
4889 Highway 17 Byp S Myrtle Beach SC 29577-6683 |
| Mailing Address |
311 4 E Judges Road Wilmington NC 28405 |
| Practice Telephone | 8435847011 |
| Practice Fax Number | 8439451355 |
| Mailing Telephone | 9107916767 |
| Mailing Fax Number | 9103992190 |
| Enumeration Date | 2018-10-10 |
| Last Update Date | 2018-10-10 |
| Authorized Official Name | WILLIAM BEASLEY (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 9107916767 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 1255323622 | 05 |
| Street Address |
4889 HIGHWAY 17 BYP S |
| City | MYRTLE BEACH |
| State | SC |
| Zip Code | 29577-6683 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124536446 | Well Care Home Health of The Lowcountry | Home Health | 1039 44th Ave N Ste 101, Myrtle Beach, SC 29577 | 2018-01-22 |
| 1518470913 | Guillot Enterprises, LLC | Hearing Instrument Specialist | 1294 Professional Dr., Suite C, Myrtle, SC 29577 | 2017-11-08 |
| 1598288227 | Ryan Shepherd | Pharmacist | 1705 South Kings Highway, Myrtle Beach, SC 29577 | 2017-07-25 |
| 1184176554 | Shannon Long | Counselor | 1293 Professional Drive, Suite D Office 222, Myrtle Beach, SC 29577 | 2016-11-01 |
| 1265898191 | Coastal Carolina Infectious Disease, LLC | Internal Medicine | 1110 London St Ste 102, Myrtle Beach, SC 29577 | 2016-01-07 |
| 1548639933 | Susan Lang | Social Worker | 1273 Professional Dr., Suite A #104, Myrtle Beach, SC 29577 | 2015-09-16 |
| 1043600893 | Kenneth Edward Smith | Counselor | 1125 48th Avenue North, Myrtle Beach, SC 29577 | 2015-02-02 |
| 1902203615 | Sc Nursing Services LLC | Home Infusion | 1297 Professional Drive, Suite 201 C3, Myrtle Beach, SC 29577 | 2014-11-24 |
| 1881007946 | Intercoastal Endo, PC | Dentist | 4382 Oleander Dr, Myrtle Beach, SC 29577 | 2014-06-06 |
| 1891115739 | Julie Hite | Pharmacist | 540 Seaboard Street, Myrtle Beach, SC 29577 | 2014-04-18 |
| Find all providers in zip 29577 | ||||
| Taxonomy Code | 2084A0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Addiction Medicine |
| A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |
| Notes: Source: American Osteopathic Board of Neurology and Psychiatry, 2007 [1/1/2008: definition added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205996303 | Susan Jayne Olson | Psychiatry & Neurology | 1297 Professional Dr, Ste 104, Myrtle Beach, SC 29577-5713 | 2006-12-11 |
| 1538229448 | Strand Psychiatric Associates Pa | Psychiatry & Neurology | 3025 Newcastle Loop, Myrtle Beach, SC 29588-4502 | 2006-12-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982037529 | Charleston Addiction Medicine, LLC | Psychiatry & Neurology | 2175 Ashley Phosphate Rd, Suite G, North Charleston, SC 29406-4181 | 2013-08-19 |
| 1104101054 | South Carolina Research Group LLC | Psychiatry & Neurology | 68 Parkway Commons Way, Greer, SC 29650-5213 | 2011-10-11 |
| 1558663294 | Michael J Huggins | Psychiatry & Neurology | 2175 Ashley Phosphate Rd, Suite G, North Charleston, SC 29406-4181 | 2010-12-01 |
| 1164746392 | Anmed Health | Psychiatry & Neurology | 800 N Fant St, Anderson, SC 29621-5708 | 2010-03-17 |
| 1922203223 | Joseph David Markowitz | Psychiatry & Neurology | 3555 Harden Street Ext Ste 141, Columbia, SC 29203 | 2007-06-18 |
| 1396957445 | Robert Holden Stafford | Psychiatry & Neurology | 910 Cook Rd, Orangeburg, SC 29118-2124 | 2007-05-03 |
| 1295824159 | Spartanburg Medical Center | Psychiatry & Neurology | 391 Serpentine Dr, Suite 400, Doctor's Center, Spartanburg, SC 29303-3096 | 2006-10-11 |
| 1750481727 | Faraz Qureshi | Psychiatry & Neurology | 109 Bee St, Charleston, SC 29401-5703 | 2006-09-22 |
| 1275643538 | Diana L. Thorne | Psychiatry & Neurology | 6439 Garners Ferry Rd, Columbia, SC 29209-1638 | 2006-08-30 |
| 1245264506 | Sam Harry Ross | Psychiatry & Neurology | 130 Highway 252, Anderson, SC 29621-5054 | 2006-07-10 |
| Find all providers with the same taxonomy | ||||
| City | MYRTLE BEACH |
| Zip Code | 29577 |
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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.