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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MRS. JUSTINE KOERNER TYE CPNP
NPI 1366724098
Nurse Practitioner - Pediatrics in Little River, SC

Active since September 20, 2011
4303 LIVE OAK DR, LITTLE RIVER, SC 29566(843) 663-8000(843) 663-1017 Get Directions Write a Review

NPPES record last updated: October 22, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Mrs. Justine Koerner Tye Cpnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. JUSTINE KOERNER TYE CPNP (NPI 1366724098) is an individual pediatrics provider in Little River, South Carolina, licensed in South Carolina (32732) and active in the NPI registry since September 2011.

NPPES Registry Identity

NPI1366724098
Entity TypeIndividualFemale
Primary Taxonomy363LP0200X
Provider Legal NameMRS. JUSTINE KOERNER TYECredential: CPNP
Location Address4303 LIVE OAK DRLittle River, SC 29566-9138
Mailing AddressPo Box 547Little River, SC 29566-0547 · (843) 663-8000 · Fax (843) 663-1017
Phone(843) 663-8000
Fax(843) 663-1017
Sole ProprietorNo
Enumeration DateSeptember 20, 2011
Last NPPES UpdateOctober 22, 2026
NPPES CertifiedOctober 22, 2026
✔ NPI 1366724098 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
Licenses✔ Licensed in SC · 32732✔ Licensed in NC · 160512✔ Licensed in NC · 5005317
4303 LIVE OAK DR, Little River, SC 29566
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Other Identifiers 3

MedicaidNP2580SC
Medicaid1366724098NC
Medicaid1558308080NC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna Healthcare, Cigna HealthCare of Arizona, Inc, UnitedHealthcare.Insurance ›

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JESSE MITCHEL RAYBON DMD
Dentist
4303 LIVE OAK DR
LITTLE RIVER, SC 29566
Horry County (843) 663-8011
JILLIAN M. SINISCALCHI AGP-NP
Nurse Practitioner (Gerontology)
4303 LIVE OAK DR
LITTLE RIVER, SC 29566
Horry County (843) 663-8000
LITTLE RIVER MEDICAL CENTER PHARMACY
Pharmacy
4303 LIVE OAK DR
LITTLE RIVER, SC 29566
Horry County (843) 663-8099
LITTLE RIVER MEDICAL CENTER INC
Dentist
4303 LIVE OAK DR
LITTLE RIVER, SC 29566
Horry County (843) 663-8000
DR. KENNETH L CRUTCHER M.D.
Family Medicine
4303 LIVE OAK DR
LITTLE RIVER, SC 29566
Horry County (843) 663-8000
ASHLEY JOAN RILEY FNP
Nurse Practitioner (Family)
4303 LIVE OAK DR
LITTLE RIVER, SC 29566
Horry County (843) 663-8294
DR. LATISHA KEARSLEY DDS
Dentist (General Practice)
4303 LIVE OAK DR
LITTLE RIVER, SC 29566
Horry County (843) 663-8000
DR. REBECCA MARIE MARKHAM DMD
Dentist (General Practice)
4303 LIVE OAK DR
LITTLE RIVER, SC 29566
Horry County (843) 663-8000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Justine Tye's NPI number?

The NPI number for Justine Tye is 1366724098. It was assigned to this individual provider in the NPPES registry on September 20, 2011.

Where is Justine Tye located?

Justine Tye practices at 4303 Live Oak Dr, Little River, SC 29566. The listed phone number is (843) 663-8000.

What is Justine Tye's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

What insurance does Justine Tye accept?

Health plans from Cigna HealthCare of Arizona, Inc, Cigna Healthcare and UnitedHealthcare list Justine Tye as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Justine Tye was last updated on October 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.