JERRY BURTON BANKS (NPI# 1578552410) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578552410 |
| Entity Type | Individual |
| Full Name | JERRY BURTON BANKS |
| Credential | MD |
| Practice Address |
920 Doug White Dr Ste 250 Myrtle Beach SC 29572-4120 |
| Practice Telephone | 8438481440 |
| Practice Fax Number | 8438392382 |
| Mailing Telephone | 8438481440 |
| Mailing Fax Number | 8438392382 |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2020-02-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 37612 | SC | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 0101232005 | VA | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | MD34440 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 1578552410 | 05 | |
| SC | 037612200 | 05 | |
| TN | 1505595 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205179504 | Jerry Allan Banks Jr. | Internal Medicine | 325 N State of Franklin Rd, Johnson City, TN 37604-6056 | 2013-04-04 |
| 1477822906 | Jerry Preston Banks | Counselor | 102 S 11th St, San Jose, CA 95112-2132 | 2011-12-29 |
| Street Address |
920 DOUG WHITE DR STE 250 |
| City | MYRTLE BEACH |
| State | SC |
| Zip Code | 29572-4120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538573670 | Stephen Meyer | Internal Medicine | 920 Doug White Dr Ste 250, Myrtle Beach, SC 29572-4120 | 2014-06-17 |
| 1295097491 | Jilian Rinehart Sansbury | Internal Medicine | 920 Doug White Dr Ste 250, Myrtle Beach, SC 29572-4120 | 2012-06-13 |
| 1427328533 | Anthony Shadiack | Family Medicine | 920 Doug White Dr Ste 250, Myrtle Beach, SC 29572-4120 | 2012-01-05 |
| 1447581301 | Vinh Tran Trinh | Internal Medicine | 920 Doug White Dr Ste 250, Myrtle Beach, SC 29572-4120 | 2010-01-15 |
| 1548596042 | Mary Jane Griffith | Nurse Practitioner | 920 Doug White Dr Ste 250, Myrtle Beach, SC 29572-4120 | 2009-10-19 |
| 1043402480 | Andrew Peter Mangano | Internal Medicine | 920 Doug White Dr Ste 250, Myrtle Beach, SC 29572-4120 | 2007-08-09 |
| 1215010020 | Sean L. Gibbs | Family Medicine | 920 Doug White Dr Ste 250, Myrtle Beach, SC 29572-4120 | 2006-10-23 |
| 1265474324 | Kevin W Shea | Internal Medicine | 920 Doug White Dr Ste 250, Myrtle Beach, SC 29572-4120 | 2006-06-12 |
| 1932140092 | Mark Richard Gobin | Internal Medicine | 920 Doug White Dr Ste 250, Myrtle Beach, SC 29572-4120 | 2006-06-09 |
| 1396782900 | Victor Eugene Collier | Internal Medicine | 920 Doug White Dr Ste 250, Myrtle Beach, SC 29572-4120 | 2006-06-01 |
| 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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386278422 | Melissa Costantini | Family Medicine | 4612 Oleander Drive Unit 102, Myrtle Beach, SC 29577-2957 | 2020-02-27 |
| 1063045565 | La Bella Md | Family Medicine | 2020 Oakheart Rd, Myrtle Beach, SC 29579-1252 | 2020-02-13 |
| 1780118414 | Georgetown Physician Associates, LLC | Family Medicine | 4320 Holmestown Rd Ste A, Myrtle Beach, SC 29588-7837 | 2017-04-19 |
| 1326594995 | Mcleod Physician Associates II | Family Medicine | 907 Startek Drive, Myrtle Beach, SC 29579-4471 | 2016-09-01 |
| 1760806160 | Myrtle Beach Physical Medicine & Rehab, LLC | Family Medicine | 4736 17 Bypass South, Myrtle Beach, SC 29588 | 2014-02-06 |
| 1972941649 | Chrystal M Coates-gal | Family Medicine | 4612 Oleander Dr Ste 102, Myrtle Beach, SC 29577-5711 | 2013-06-04 |
| 1336324169 | Patrick Keith Ryan | Family Medicine | 4600 Oleander Dr Ste C, Agape Physicians Care, Myrtle Beach, SC 29577-5897 | 2007-12-28 |
| 1639280647 | David Wayne Murphy | Family Medicine | 6010 Highway 707 Ste 100, Myrtle Beach, SC 29588-7321 | 2006-08-31 |
| 1740215714 | Ernest R Gelb | Family Medicine | 4320 Holmestown Rd, Myrtle Beach, SC 29588-7837 | 2006-07-11 |
| 1821033085 | Steven Alan Meixel | Family Medicine | 4301 Dick Pond Rd, Myrtle Beach, SC 29588-6807 | 2006-06-19 |
| Find all providers in MYRTLE BEACH | ||||
| 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.