GEORGETOWN PHYSICIAN ASSOCIATES, LLC (NPI# 1780118414) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780118414 |
| Entity Type | Organization |
| Organization Name | GEORGETOWN PHYSICIAN ASSOCIATES, LLC |
| Other Organization Name | TIDELANDS HEALTH FAMILY MEDICINE |
| Practice Address |
4320 Holmestown Rd Ste A Myrtle Beach SC 29588-7837 |
| Mailing Address |
Po Box 421718 Georgetown SC 29442-4203 |
| Practice Telephone | 8436528440 |
| Practice Fax Number | 8436528441 |
| Mailing Telephone | 8435208883 |
| Mailing Fax Number | 8436528422 |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2020-05-01 |
| Authorized Official Name | ELIZABETH SUTHERLAND WARD (EVP & CFO) |
| Authorized Official Telephone | 8435277102 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | GP7739 | 05 |
| Other Name | Type Code |
|---|---|
| Tidelands Health Family Medicine | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053967943 | Georgetown Physician Associates, LLC | Pediatrics | 4320 Holmestown Rd Ste B, Myrtle Beach, SC 29588-7837 | 2019-08-15 |
| 1053704627 | Georgetown Physician Associates, LLC | Anesthesiology | 4040 Highway 17 Unit 206, Murrells Inlet, SC 29576-5098 | 2015-03-06 |
| 1598179947 | Georgetown Physician Associates, LLC | Dermatology | 4033 Highway 17, Suite 105, Murrells Inlet, SC 29576-5032 | 2014-06-13 |
| 1548604366 | Georgetown Physician Associates, LLC | Emergency Medicine | 4367 Riverwood Dr Unit 104, Murrells Inlet, SC 29576-4381 | 2013-04-23 |
| 1548501976 | Georgetown Physician Associates, LLC | Obstetrics & Gynecology | 606 Black River Rd Ste 300, Georgetown, SC 29440-3304 | 2013-03-11 |
| 1235475930 | Georgetown Physician Associates, LLC | Family Medicine | 2347 S Highway 17, Murrells Inlet, SC 29576-7611 | 2012-12-27 |
| 1588716815 | Georgetown Physician Associates, LLC | Clinic/Center | 456 N Main St, Hemingway, SC 29554 | 2007-01-17 |
| 1326655333 | Georgetown Physician Associates, LLC | Otolaryngology | 2200 Crow Ln Ste 301, Myrtle Beach, SC 29577-1663 | 2020-09-24 |
| 1477163988 | Georgetown Physician Associates, LLC | Internal Medicine | 2200 Crow Ln Ste 301, Myrtle Beach, SC 29577-1663 | 2020-08-10 |
| 1124673793 | Georgetown Physician Associates, LLC | Clinic/Center | 2200 Crow Ln Ste 201, Myrtle Beach, SC 29577-1663 | 2019-08-09 |
| Street Address |
4320 HOLMESTOWN RD STE A |
| City | MYRTLE BEACH |
| State | SC |
| Zip Code | 29588-7837 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740819309 | Forrest Halsey Westley | Pharmacist | 3072 Dick Pond Rd. Suite 2, Myrtle Beach, SC 29588 | 2020-04-06 |
| 1588124176 | The Counseling Center of Sayebrook | Counselor | 106 Lansford Court Suite 202, Myrtle Beach, SC 29588 | 2019-03-21 |
| 1134631443 | Solid Foundations, LLC | Clinic/Center | 4325 Dick Pond Road, Suite E, Myrtle Beach, SC 29588 | 2017-10-26 |
| 1316496037 | Grand Strand Rehab and Nursing Center, LLC | Skilled Nursing Facility | 4452 Socastee Boulevard, Myrtle Beach, SC 29588 | 2016-09-22 |
| 1386092039 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 1370 South Commons Drive, Suite 102, Myrtle Beach, SC 29588 | 2016-06-02 |
| 1114314531 | Allison Smith | Physical Therapy Assistant | 4870 Socastee Blvd, Myrtle Beach, SC 29588 | 2015-04-23 |
| 1760806160 | Myrtle Beach Physical Medicine & Rehab, LLC | Family Medicine | 4736 17 Bypass South, Myrtle Beach, SC 29588 | 2014-02-06 |
| 1801228499 | Robin Ruth Gause | Lactation Consultant, Non-RN | 510 Fairwood Lakes Ave, 14-c, Myrtle Beach, SC 29588 | 2013-08-06 |
| 1124386438 | Horace Earl Ferguson Jr. | Technician/Technologist | 4535 Dick Pond Road, A, Myrtle Beach, SC 29588 | 2012-04-25 |
| 1831463652 | Medeyecare, LLC | Technician/Technologist | 4335 Socastee Blvd, Unit A, Myrtle Beach, SC 29588 | 2012-02-24 |
| Find all providers in zip 29588 | ||||
| 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 |
| 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 |
| 1861448086 | Christopher Andrew Borst | Family Medicine | 1220 21st Ave N, Myrtle Beach, SC 29577-7401 | 2006-05-26 |
| Find all providers in MYRTLE BEACH | ||||
| City | MYRTLE BEACH |
| Zip Code | 29588 |
Please comment or provide details below to improve the information on GEORGETOWN PHYSICIAN ASSOCIATES, LLC.
| 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.