TIDELANDS HEALTH
NPI 1134002439
Clinic/Center - Primary Care in Murrells Inlet, SC

NPI Status: Active since July 26, 2025

Contact Information

11916 HIGHWAY 707 STE D
MURRELLS INLET, SC
ZIP 29576
Phone: (843) 652-8450

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  • Organization
  • Clinic/Center
  • Primary Care
  • CLIA Number: 42D2284309
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 06-20-2027

About TIDELANDS HEALTH

This page provides the complete NPI Profile along with additional information for Tidelands Health, a primary care provider established in Murrells Inlet, South Carolina operating as a Clinic/center, focusing in primary care . The healthcare provider is registered in the NPI registry with number 1134002439 assigned on July 2025. The practitioner's primary taxonomy code is 261QP2300X. The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Tyler Elise Kelly (Aprn)

NPI
1134002439
Provider Name
TIDELANDS HEALTH
Entity Type
Organization
Location Address
11916 HIGHWAY 707 STE D MURRELLS INLET, SC 29576
Location Phone
(843) 652-8450
Mailing Address
6723 GENESIS DRIVE MURRELLS INLET, SC 29576
Mailing Phone
(631) 327-8894
Mailing Fax
(631) 327-8894
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-26-2025
Last Update Date
07-26-2025
Code Navigator

A primary care provider (PCP) like Tidelands Health sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, 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

Clinic/Center Primary Care

Taxonomy Code
261QP2300X
Type
Ambulatory Health Care Facilities

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

TYLER ELISE KELLY

Authorized Official Title
APRN
Authorized Official Phone
(631) 327-8894

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
42D2284309
Facility Type
Physician Office
Certificate Effective Date
June 21, 2025
Certificate Expiration Date
June 20, 2027
Laboratory Director
DR. ROXANNE LATIMER
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Tidelands Health 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 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 1134002439, we treat the final digit (9) 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 51. The final step is to find the difference between that total and the next multiple of ten (60 - 51 = 9).

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.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
3
Doubled → 6
Pos 4
4
Unchanged
Pos 5
0
Doubled → 0
Pos 6
0
Unchanged
Pos 7
2
Doubled → 4
Pos 8
4
Unchanged
Pos 9
3
Doubled → 6
Check
9
Target digit
Regular digit Doubled digit Check digit

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.

1 → 2 3 → 6 0 → 0 2 → 4 3 → 6

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 6 + 4 + 0 + 0 + 4 + 4 + 6 + 24 = 51

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 51 is 60. The difference is the calculated check digit.

60 - 51 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1134002439.

Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Family Medicine
11916 HIGHWAY 707 STE D
MURRELLS INLET, SC 29576
Family Medicine
11916 HIGHWAY 707 STE D
MURRELLS INLET, SC 29576
Family Medicine
11916 HIGHWAY 707 STE D
MURRELLS INLET, SC 29576

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1134002439, enumerated as an "organization" on July 26, 2025.

The provider is located at 11916 HIGHWAY 707 STE D MURRELLS INLET, SC 29576 and the phone number is (843) 652-8450.

Clinic/Center with taxonomy code 261QP2300X and a focus in Primary Care.