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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363A00000X | Physician Assistant | MA001516L | PA | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
1101 JOHNSON AVE |
City | MYRTLE BEACH |
State | SC |
Zip Code | 29577-1893 |
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 |
Find all providers in the same location |
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 | 363A00000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
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. |
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 |
Find all providers in MYRTLE BEACH |
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.