WACCAMAW DERMATOLOGY, LLC
NPI 1962449181
Dermatology in Myrtle Beach, SC
NPI Status: Active since May 31, 2006
Contact Information
917 MEDICAL CIRCLE
MYRTLE BEACH, SC
ZIP 29572
Phone: (843) 449-0453
Fax: (843) 282-1910
- Organization
- Dermatology
- Accepts Insurance
- CLIA Number: 42D0957486
- CLIA Cert. Type: Practitioner Other
- CLIA Exp. Date: 10-17-2025
About WACCAMAW DERMATOLOGY, LLC
This page provides the complete NPI Profile along with additional information for Waccamaw Dermatology, Llc, a provider established in Myrtle Beach, South Carolina operating as a Dermatology. The healthcare provider is registered in the NPI registry with number 1962449181 assigned on May 2006. The practitioner's primary taxonomy code is 207N00000X. The provider is registered as an organization and their NPI record was last updated 3 years ago. Waccamaw Dermatology, Llc operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is Dr. Brandon J. Coakley Md (Managing Partner)
- NPI
- 1962449181
- Provider Name
- WACCAMAW DERMATOLOGY, LLC
- Entity Type
- Organization
- Location Address
- 917 MEDICAL CIRCLE MYRTLE BEACH, SC 29572
- Location Phone
- (843) 449-0453
- Location Fax
- (843) 282-1910
- Mailing Address
- 917 MEDICAL CIRCLE MYRTLE BEACH, SC 29572
- Mailing Phone
- (843) 449-0453
- Mailing Fax
- (843) 282-1910
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-31-2006
- Last Update Date
- 03-22-2022
- Code Navigator
A dermatologist like Waccamaw Dermatology, Llc is a medical specialty involving the management of skin conditions and diseases. Dermatologists diagnose some sexually transmitted diseases, warts, cancer, acne, dermatitis and may offer cosmetic treatments, and therapies that reduce age spots and wrinkles.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dermatology
- Taxonomy Code
- 207N00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Clear Silver - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Clear Silver with $0 Insulin Options - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Gold with Atrium Health - HMO
- Complete Gold with Atrium Health + Vision + Adult Dental - HMO
- Complete Silver with Atrium Health - HMO
- Complete Silver with Atrium Health + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Bronze with Atrium Health - HMO
- Blue Direction Silver 1 - POS
- Blue Direction Silver 1 + Adult Vision - POS
- Blue Direction Silver 2 - POS
- Blue Direction Standard Gold - POS
- Blue Direction Standard Silver - POS
- Blue Pee Dee Bronze 1 - HMO
- Blue Pee Dee Bronze 2 - HMO
- Blue Pee Dee Gold 1 - HMO
- Blue Pee Dee Silver 1 - HMO
- Blue Pee Dee Silver 2 - HMO
- First Choice Next Bronze Essential - HMO
- First Choice Next Bronze Premier - HMO
- First Choice Next Bronze Signature - HMO
- First Choice Next Gold Deluxe - HMO
- First Choice Next Gold Signature - HMO
- First Choice Next Silver Deluxe - HMO
- First Choice Next Silver Premier - HMO
- First Choice Next Silver Signature - HMO
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 8 - HMO
- Silver 1 - HMO
- Silver 1 with Adult Vision Services - HMO
- Silver 12 - HMO
- Silver 8 - HMO
- Standard Expanded Bronze WellCare - PPO
- Standard Gold WellCare - PPO
- Standard Silver WellCare - PPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| GP1554 | MEDICAID (05) | SC |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 42D0957486
- Facility Type
- Practitioner Other
- Certificate Effective Date
- October 18, 2023
- Certificate Expiration Date
- October 17, 2025
- Laboratory Director
- DR. STEPHEN B. HAMMOND
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Waccamaw Dermatology, Llc after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 9 | 6 | 2 | 4 | 4 | 9 | 1 | 8 | 1 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 9 | 12 | 2 | 8 | 4 | 18 | 1 | 16 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 9 + 1 + 2 + 2 + 8 + 4 + 1 + 8 + 1 + 1 + 6 + 24 = 69 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 69 = 1 | 1 | ||||||||
The NPI number 1962449181 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following provider is registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1437308814 | WACCAMAW DERMATOLOGY AND PLASTIC SURGERY Organization | Dermatology | 917 MEDICAL CIRCLE MYRTLE BEACH, SC 29572 (843) 449-0453 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1962449181, enumerated in the NPI registry as an "organization" on May 31, 2006
The provider is located at 917 Medical Circle Myrtle Beach, Sc 29572 and the phone number is (843) 449-0453
This medical organization specializes in Dermatology with taxonomy code 207N00000X
The provider might be accepting Accepts: Ambetter from Absolute Total Care, Ambetter of. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 42D0957486 for a "practitioner other" facility with a CLIA Certificate of Compliance. This CLIA certificate is issued after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing..
This NPI record was last updated on May 31, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.