TIDELANDS HEALTH PEDIATRICS
NPI 1053967943
Pediatrics in Myrtle Beach, SC
NPI Status: Active since August 15, 2019
Contact Information
4320 HOLMESTOWN RD STE B
MYRTLE BEACH, SC
ZIP 29588
Phone: (843) 652-8440
Fax: (843) 652-8441
- Organization
- Pediatrics
- Accepts Insurance
- CLIA Number: 42D2172838
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 09-30-2027
About TIDELANDS HEALTH PEDIATRICS
This page provides the complete NPI Profile along with additional information for Tidelands Health Pediatrics, a pediatrician established in Myrtle Beach, South Carolina operating as a Pediatrics. The healthcare provider is registered in the NPI registry with number 1053967943 assigned on August 2019. The practitioner's primary taxonomy code is 208000000X. The provider is registered as an organization and their NPI record was last updated 6 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as Tidelands Health Pediatrics. The authorized official of this NPI record is Elizabeth Sutherland Ward (Evp & Cfo)
- NPI
- 1053967943
- Provider Legal Name
- GEORGETOWN PHYSICIAN ASSOCIATES, LLC
- Other Organization Name
- TIDELANDS HEALTH PEDIATRICS
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 4320 HOLMESTOWN RD STE B MYRTLE BEACH, SC 29588
- Location Phone
- (843) 652-8440
- Location Fax
- (843) 652-8441
- Mailing Address
- PO BOX 421718 GEORGETOWN, SC 29442
- Mailing Phone
- (843) 652-8440
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 08-15-2019
- Last Update Date
- 05-01-2020
- Code Navigator
A pediatrician like Tidelands Health Pediatrics is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.
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
Pediatrics
- Taxonomy Code
- 208000000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Standard Expanded Bronze - HMO
- Standard Gold - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - 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
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Bronze with Atrium Health - HMO
- Elite Bronze with Atrium Health + Vision + Adult Dental - HMO
- Enhanced Asthma/COPD Care Silver with $0 Drug Options - HMO
- Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Bronze with Atrium Health - HMO
- Everyday Bronze with Atrium Health + Vision + Adult Dental - HMO
- Focused Silver with Atrium Health - HMO
- Focused Silver with Atrium Health + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Expanded Bronze with Atrium Health - HMO
- Blue Direction Bronze 1 - POS
- Blue Direction Silver 1 - POS
- Blue Direction Silver 1 + Adult Vision - POS
- Blue Direction Silver 2 - POS
- Blue Direction Standard Expanded Bronze - 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
- Blue Pee Dee Silver 2 + Adult Vision - HMO
- Blue Pee Dee Standard Expanded Bronze - HMO
- Blue Pee Dee Standard Gold - HMO
- Blue Pee Dee Standard Silver - HMO
- Blue VirtuConnect Bronze 1 - EPO
- Blue VirtuConnect Gold 1 - EPO
- Blue VirtuConnect Silver 1 - EPO
- BlueEssentials Bronze 4 - EPO
- First Choice Next Bronze Essential - HMO
- First Choice Next Bronze Premier - HMO
- First Choice Next Bronze Signature - HMO
- First Choice Next Gold Premier - HMO
- First Choice Next Gold Signature - HMO
- First Choice Next Silver Essential - HMO
- First Choice Next Silver Premier - HMO
- First Choice Next Silver Signature - HMO
- Molina Gold Core 1640 - HMO
- Molina Gold Core 1640 Plus with Adult Dental and Vision - HMO
- Molina Gold Core 1640 Plus with Adult Vision - HMO
- Molina Gold Standard - HMO
- Molina Gold Value - HMO
- Molina Gold Value Plus with Adult Dental and Vision - HMO
- Molina Gold Value Plus with Adult Vision - HMO
- Molina Silver Core - HMO
- Molina Silver Core Plus with Adult Dental and Vision - HMO
- Molina Silver Core Plus with Adult Vision - HMO
- Molina Silver Saver - HMO
- Molina Silver Standard - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
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
- 42D2172838
- Facility Type
- Physician Office
- Certificate Effective Date
- October 01, 2025
- Certificate Expiration Date
- September 30, 2027
- Laboratory Director
- LUCRETIA CARTER
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Tidelands Health Pediatrics in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1053967943, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 3).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 67 is 70. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1053967943, enumerated as an "organization" on August 15, 2019.
The provider is located at 4320 HOLMESTOWN RD STE B MYRTLE BEACH, SC 29588 and the phone number is (843) 652-8440.
Pediatrics with taxonomy code 208000000X.
The provider might be accepting Accepts: Ambetter from Absolute Total Care, Ambetter of. Please consult your insurance carrier or call the provider to verify.
