RANDALL PAUL GROVE


Address: 1101 Johnson Ave, Myrtle Beach, SC 29577-1893
Phone: 8434770177

RANDALL PAUL GROVE (NPI# 1619969250) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1619969250
Entity Type Individual
Full Name RANDALL PAUL GROVE
Credential PA
Practice Address 1101 Johnson Ave
Myrtle Beach
SC 29577-1893
Practice Telephone 8434770177
Mailing Telephone 8434770177
Enumeration Date 2005-08-19
Last Update Date 2017-10-19
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363A00000X Physician Assistant MA001516L PA Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 1101 JOHNSON AVE
City MYRTLE BEACH
State SC
Zip Code 29577-1893

Providers in the same location

NPI Name Taxonomy Address Enumeration
1629617485 Tarzaris Mack Social Worker 1101 Johnson Ave, Myrtle Beach, SC 29577-1893 2019-12-27
1720633621 Ethel Mae Santai Physical Therapist 1101 Johnson Ave, Myrtle Beach, SC 29577-1893 2019-08-07
1912560095 Stephen Francis Kovacs IIi Social Worker 1101 Johnson Ave, Myrtle Beach, SC 29577-1893 2019-04-15
1831676857 Stacey M Fontaine Social Worker 1101 Johnson Ave, Myrtle Beach, SC 29577-1893 2018-07-23
1770077588 Richard Mehlbrech Physical Therapist 1101 Johnson Ave, Myrtle Beach, SC 29577 2018-06-15
1013367960 Willa Fry Audiologist 1101 Johnson Ave, Suite 204, Myrtle Beach, SC 29577-1893 2016-06-21
1114382264 Paul Anama Physical Therapist 1101 Johnson Ave, Rm 138, Myrtle Beach, SC 29577-1893 2015-12-16
1518346097 Jamie Wright Social Worker 1101 Johnson Ave, Suite 204, Myrtle Beach, SC 29577-1893 2015-05-29
1164810297 Charleston Vamc Clinic/Center 1101 Johnson Ave, Suite R-2a, Myrtle Beach, SC 29577-1893 2014-12-23
1447653415 Kimberly Patricia Cuddy Psychologist 1101 Johnson Ave, Myrtle Beach, SC 29577 2014-10-03
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1053910596 Sarah Xiao Jing Jarema Physician Assistant 1211 Hadley Cir Unit 4301, Myrtle Beach, SC 29577-8219 2020-10-24
1750553152 Daniella Deperi Physician Assistant 5046 Highway 17 Byp S Ste 103, Myrtle Beach, SC 29588-4503 2008-03-26
1831204676 Mercedes Zimmerman Davis Physician Assistant 106 Lansford Pl, Myrtle Beach, SC 29588-6979 2006-08-20
1033181193 Tracy Reymore Black Physician Assistant 8208 Devon Court, Suite B, Myrtle Beach, SC 29572 2006-02-03
1487655106 Ashley Smith Wilson Physician Assistant 945 82nd Parkway, Myrtle Beach, SC 29572 2005-08-03
1487294179 Jimmy Gregory Stevens Physician Assistant 920 Doug White Dr Ste 130, Myrtle Beach, SC 29572-4120 2020-01-09
1225686835 Kaycee Lauren Villane Physician Assistant 920 Doug White Dr Ste 130, Myrtle Beach, SC 29572-4120 2019-08-27
1477100766 Sarah Snyder Brown Physician Assistant 809 82nd Pkwy, Myrtle Beach, SC 29572-4607 2019-08-21
1619523412 Strand Physician Specialists, Pa Physician Assistant 945 82nd Pkwy, Myrtle Beach, SC 29572-4612 2019-08-16
1700430345 Korreda Gause Physician Assistant 8120 Rourk St, Myrtle Beach, SC 29572-4127 2019-07-31
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Competitor

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City MYRTLE BEACH
Zip Code 29577

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Dataset Information

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.

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