TIDELANDS HEALTH GASTROENTEROLOGY – NPI #1093139420
Internal Medicine

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

TIDELANDS HEALTH GASTROENTEROLOGY is a provider located in GEORGETOWN, SC. NPPES has assigned the NPI number 1093139420 to TIDELANDS HEALTH GASTROENTEROLOGY on February 05, 2014. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “TIDELANDS HEALTH GASTROENTEROLOGY” is a dba name, the actual legal business name for this organization is GEORGETOWN PHYSICIAN ASSOCIATES. According to the NPI Registry, there are 3 additional location(s) assigned to this provider which are listed below. The primary taxonomy selected by this provider is 207RG0100X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine, specializing in Gastroenterology

The NPI profile was previously updated about 6 years ago on Jun 25, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for TIDELANDS HEALTH GASTROENTEROLOGY below.

NPI Profile for
GEORGETOWN PHYSICIAN ASSOCIATES

NPI Number
1093139420
Enumeration Date

(more than 12 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
GEORGETOWN PHYSICIAN ASSOCIATES
Doing Business As (dba): TIDELANDS HEALTH GASTROENTEROLOGY
Primary location
1011 N FRASER ST
GEORGETOWN, SC 29440
Phone: (843) 527-3428 Fax: (843) 546-8216
3 Other location(s):
4040 Highway 17 Unit 302
Murrells Inlet, SC 29576-5098
Phone: (843) 652-8290
Fax: (843) 652-8299
2200 Crow Ln Ste 302
Myrtle Beach, SC 29577-1663
Phone: (843) 848-5320
Fax: (843) 848-5325
4301 Dick Pond Rd
Myrtle Beach, SC 29588-6807
Phone: (843) 652-8290
Fax: (843) 652-8299
Mailing address
PO BOX 421718
GEORGETOWN, SC 29442-4203
Phone: (843) 520-8883 Fax: (843) 652-8422
Organization Subpart
No
Authorized Official
ELIZABETH WARD
EVP & CFO
Phone: (843) 527-7102
Updated
Certification Date
Jun 25, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for TIDELANDS HEALTH GASTROENTEROLOGY

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDSCGP6485
MEDICAIDSCGP8109
MEDICAIDSCGP8837
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207RG0100X
- Internal Medicine / Gastroenterology (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.