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BROADWAY MEDICAL INNOVATION, LLC
NPI 1467108514
Internal Medicine in Little River, SC

Active since February 28, 2022
100 WATER GRANDE BLVD, LITTLE RIVER, SC 29566(843) 655-0004 Get Directions Write a Review

NPPES record last updated: April 22, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 22, 2026, Feb 28, 2022 (2 updates tracked since 2022).

About Broadway Medical Innovation, Llc NPPES

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

BROADWAY MEDICAL INNOVATION, LLC (NPI 1467108514) is a healthcare organization registered as an internal medicine in Little River, South Carolina and active in the NPI registry since February 2022. The organization lists Victor Aguin Melendez, Owner, as its authorized official.

NPPES Registry Identity

NPI1467108514
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameBROADWAY MEDICAL INNOVATION, LLC
Location Address100 WATER GRANDE BLVDLittle River, SC 29566
Mailing Address4016 River Oaks Dr Ste 6 Pmb 178Myrtle Beach, SC 29579-6674 · (843) 655-0004
Phone(843) 655-0004
Organization SubpartNo
Authorized OfficialVictor Aguin MelendezOwner · (843) 655-0004
Enumeration DateFebruary 28, 2022
Last NPPES UpdateApril 22, 20262 updates tracked since enumeration
NPPES CertifiedApril 22, 2026
✔ NPI 1467108514 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
100 WATER GRANDE BLVD, Little River, SC 29566
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of South Carolina.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Broadway Medical Innovation, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Broadway Medical Innovation, LLC, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (4)

Mary Harding, APRN
Nurse Practitioner
NPI 1639557531
3600 SEA MOUNTAIN HWY, SUITE MAIN STREET PHYSICIANS
Little River, SC 29566
(800) 491-0909
✔ PECOS✔ Accepts Medicare0.7 mi
Matthew Zeuschner, AGACNP
Nurse Practitioner
NPI 1629684576
107 WOODWIND COURT
Myrtle Beach, SC 29572
(843) 945-1151
✔ PECOS✔ Accepts Medicare11 mi
Victor Aguin Melendez, M.D.
Internal Medicine
NPI 1538563903
4016 RIVER OAKS DR STE 6
Myrtle Beach, SC 29579
(843) 655-0004
✔ PECOS✔ Accepts Medicare14 mi
Lindsey States, FNP
Nurse Practitioner
NPI 1457668386
200 MIDDLEBURG DR
Myrtle Beach, SC 29579
(843) 903-6650
✔ PECOS✔ Accepts Medicare18 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Broadway Medical Innovation, LLC's NPI number?

The NPI number for Broadway Medical Innovation, LLC is 1467108514. It was assigned to this organization in the NPPES registry on February 28, 2022.

Where is Broadway Medical Innovation, LLC located?

Broadway Medical Innovation, LLC is located at 100 Water Grande Blvd, Little River, SC 29566. The listed phone number is (843) 655-0004.

What is Broadway Medical Innovation, LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Broadway Medical Innovation, LLC enrolled in Medicare?

Yes. Broadway Medical Innovation, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Broadway Medical Innovation, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Broadway Medical Innovation, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (3) and Internal Medicine (1). Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Broadway Medical Innovation, LLC accept?

Health plans from BlueCross BlueShield of South Carolina list Broadway Medical Innovation, LLC 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 Broadway Medical Innovation, LLC was last updated on April 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.