WACCAMAW PAIN GROUP, LLC - NPI NUMBER 1780940312

Summary

Provider Name: WACCAMAW PAIN GROUP, LLC

NPI Number: 1780940312

Clasification: Anesthesiology (207L00000X)

Address:
4040 HIGHWAY 17 BYPASS
SUITE 206
MURRELLS INLET, SC
ZIP 29576

Phone Number: (843) 652-8260



Detailed Information

WACCAMAW PAIN GROUP, LLC is an anesthesiologist in Murrells Inlet, SC. The provider is an anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery. The assigned NPI number for this provider is 1780940312 and is registered as an organization entity type and is a multi-specialty group.

The provider's business address is:

4040 HIGHWAY 17 BYPASS
SUITE 206
MURRELLS INLET, SC
ZIP 29576-033
Phone: (843) 652-8260

The provider's authorized official is Rick Kaylor .
The authorized official title is Authorized Representative and has the following contact phone number (843) 652-1100.

The enumeration date for this NPI number is 4/9/2012 and was last updated on 4/9/2012.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 207L00000X Anesthesiology Yes

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1780940312 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 2 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
3 Employer Identification Number EIN The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
4 Provider Organization Name Legal Business Name WACCAMAW PAIN GROUP, LLC The name of the organization provider. If the provider is an organization, this is the legal business name.
5 Provider First Line Business Practice Location Address 4040 HIGHWAY 17 BYPASS The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
6 Provider Second Line Business Practice Location Address SUITE 206 The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
7 Provider Business Practice Location Address City Name MURRELLS INLET The city name in the location address of the provider being identified.
8 Provider Business Practice Location Address State Name SC The State code in the location of the provider being identified.
9 Provider Business Practice Location Address Postal Code 295765033 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
10 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
11 Provider Business Practice Location Address Telephone Number 8436528260 The telephone number associated with the location address of the provider being identified.
12 Provider Enumeration Date 4/9/2012 The date the provider was assigned a unique identifier (assigned an NPI).
13 Last Update Date 4/9/2012 The date that a record was last updated or changed.
14 Authorized Official Last Name KAYLOR The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
15 Authorized Official First Name RICK The first name of the authorized official.
16 Authorized Official Title or Position AUTHORIZED REPRESENTATIVE The title or position of the authorized official.
17 Authorized Official Telephone Number 8436521100 The 10-position telephone number of the authorized official.
18 Healthcare Provider Taxonomy Code 1 207L00000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
19 Healthcare Provider Primary Taxonomy Switch 1 Y
20 Is Organization Subpart N
21 Healthcare Provider Taxonomy Group 1 193200000X MULTI-SPECIALTY GROUP

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This page was last updated on: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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