SOUTH CAROLINA INTERVENTIONAL PAIN - D, LLC
NPI 1104791995
Pain Medicine - Interventional Pain Medicine in Myrtle Beach, SC
NPI Status: Active since October 09, 2025
Contact Information
199 VILLAGE CENTER BLVD STE 120
MYRTLE BEACH, SC
ZIP 29579
Phone: (770) 962-3642
Fax: (770) 962-3643
- Organization
- Pain Medicine
- Interventional Pain Medicine
- CLIA Number: 42D2335548
- CLIA Cert. Type: Ambulatory Surgery Center
- CLIA Exp. Date: 12-11-2027
About SOUTH CAROLINA INTERVENTIONAL PAIN - D, LLC
This page provides the complete NPI Profile along with additional information for South Carolina Interventional Pain - D, Llc, a provider established in Myrtle Beach, South Carolina operating as a Pain Medicine, focusing in interventional pain medicine . The healthcare provider is registered in the NPI registry with number 1104791995 assigned on October 2025. The practitioner's primary taxonomy code is 208VP0014X. The provider is registered as an organization and their NPI record was last updated one year 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 authorized official of this NPI record is Amit Patel Md (Ceo)
- NPI
- 1104791995
- Provider Name
- SOUTH CAROLINA INTERVENTIONAL PAIN - D, LLC
- Entity Type
- Organization
- Location Address
- 199 VILLAGE CENTER BLVD STE 120 MYRTLE BEACH, SC 29579
- Location Phone
- (770) 962-3642
- Location Fax
- (770) 962-3643
- Mailing Address
- 455 PHILIP BLVD STE 140 LAWRENCEVILLE, GA 30046
- Mailing Phone
- (770) 962-3642
- Mailing Fax
- (770) 962-3643
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-09-2025
- Last Update Date
- 10-09-2025
- Code Navigator
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
Pain Medicine Interventional Pain Medicine
- Taxonomy Code
- 208VP0014X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment.
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.
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
- 42D2335548
- Facility Type
- Ambulatory Surgery Center
- Certificate Effective Date
- December 12, 2025
- Certificate Expiration Date
- December 11, 2027
- Laboratory Director
- AMIT S. PATEL
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to South Carolina Interventional Pain - D, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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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 1104791995, we treat the final digit (5) 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 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).
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 65 is 70. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1104791995, enumerated as an "organization" on October 09, 2025.
The provider is located at 199 VILLAGE CENTER BLVD STE 120 MYRTLE BEACH, SC 29579 and the phone number is (770) 962-3642.
Pain Medicine with taxonomy code 208VP0014X and a focus in Interventional Pain Medicine.
