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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

TIDAL PINES PRIMARY CARE LLC
NPI 1518864925
Clinic/Center - Primary Care in Myrtle Beach, SC

Active since October 20, 2026
733 CAROLINA FARMS BLVD STE 105, MYRTLE BEACH, SC 29579(843) 997-5690 Get Directions Write a Review

NPPES record added: October 20, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Tidal Pines Primary Care Llc NPPES

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

TIDAL PINES PRIMARY CARE LLC (NPI 1518864925) is a healthcare organization registered as a primary care in Myrtle Beach, South Carolina and active in the NPI registry since October 2026. The organization lists Kevan Fegely, Owner, as its authorized official.

NPPES Registry Identity

NPI1518864925
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameTIDAL PINES PRIMARY CARE LLC
Location Address733 CAROLINA FARMS BLVD STE 105Myrtle Beach, SC 29579-3529
Mailing Address6650 Rivers Ave Ste 105North Charleston, SC 29406-4829
Phone(843) 997-5690
Organization SubpartNo
Authorized OfficialKevan FegelyOwner · (843) 997-5690
Enumeration DateOctober 20, 2026
NPPES CertifiedOctober 20, 2026
✔ NPI 1518864925 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
733 CAROLINA FARMS BLVD STE 105, Myrtle Beach, SC 29579
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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 Tidal Pines Primary Care LLC's NPI number?

The NPI number for Tidal Pines Primary Care LLC is 1518864925. It was assigned to this organization in the NPPES registry on October 20, 2026.

Where is Tidal Pines Primary Care LLC located?

Tidal Pines Primary Care LLC is located at 733 Carolina Farms Blvd Ste 105, Myrtle Beach, SC 29579. The listed phone number is (843) 997-5690.

What is Tidal Pines Primary Care LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

When was this NPI record last updated?

The NPPES record for Tidal Pines Primary Care LLC was last updated on October 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.