SOUTHERN SHORES UROGYNECOLOGY AND PELVIC RECONSTRUCTIVE SURGERY PC
NPI 1669188538
Obstetrics & Gynecology - Urogynecology and Reconstructive Pelvic Surgery in Myrtle Beach, SC
About Southern Shores Urogynecology And Pelvic Reconstructive Surgery Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTHERN SHORES UROGYNECOLOGY AND PELVIC RECONSTRUCTIVE SURGERY PC (NPI 1669188538) is a healthcare organization registered as an urogynecology and reconstructive pelvic surgery in Myrtle Beach, South Carolina and active in the NPI registry since January 2023. The organization holds a CLIA Waiver certificate valid through January 8, 2027 and lists Janet E Harris-hicks, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted 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)
Southern Shores Urogynecology And Pelvic Reconstructive Surgery Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Southern Shores Urogynecology And Pelvic Reconstructive Surgery PC, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 3 within 10 miles. They are listed nearest first.
Clinicians, nearest first (4)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 42D2274675
Southern Shores Urogynecology · Myrtle Beach, SCFrequently 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 Southern Shores Urogynecology And Pelvic Reconstructive Surgery PC's NPI number?
The NPI number for Southern Shores Urogynecology And Pelvic Reconstructive Surgery PC is 1669188538. It was assigned to this organization in the NPPES registry on January 25, 2023.
Where is Southern Shores Urogynecology And Pelvic Reconstructive Surgery PC located?
Southern Shores Urogynecology And Pelvic Reconstructive Surgery PC is located at 1021 Cipriana Dr Ste 250, Myrtle Beach, SC 29572. The listed phone number is (843) 895-2120.
What is Southern Shores Urogynecology And Pelvic Reconstructive Surgery PC's specialty?
The primary specialty registered for this NPI is Obstetrics & Gynecology, specializing in Urogynecology and Reconstructive Pelvic Surgery, with taxonomy code 207VF0040X.
Is Southern Shores Urogynecology And Pelvic Reconstructive Surgery PC enrolled in Medicare?
Yes. Southern Shores Urogynecology And Pelvic Reconstructive Surgery PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Southern Shores Urogynecology And Pelvic Reconstructive Surgery PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Southern Shores Urogynecology And Pelvic Reconstructive Surgery PC. 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 Obstetrics/Gynecology (1). Of these, 2 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Southern Shores Urogynecology And Pelvic Reconstructive Surgery PC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 42D2274675) is associated with this NPI, valid through January 8, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Southern Shores Urogynecology And Pelvic Reconstructive Surgery PC accept?
Health plans from BlueCross BlueShield of South Carolina and Molina Healthcare list Southern Shores Urogynecology And Pelvic Reconstructive Surgery PC 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 Southern Shores Urogynecology And Pelvic Reconstructive Surgery PC was last updated on January 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.
# Southern Shores Urogynecology And Pelvic Reconstructive Surgery Pc · NPI 1669188538
Urogynecology and Reconstructive Pelvic Surgery organization in Myrtle Beach, South Carolina. Organization record, active in the CMS NPPES registry since January 25, 2023.
## Identity
- **NPI:** 1669188538 (Entity type: Organization)
- **Enumerated:** January 25, 2023
- **Primary specialty:** Obstetrics & Gynecology - Urogynecology and Reconstructive Pelvic Surgery · taxonomy 207VF0040X
- **Organization subpart:** No
- **Authorized official:** Janet Harris-Hicks, OWNER
## Practice location
- **Address:** 1021 CIPRIANA DR STE 250, Myrtle Beach, SC 29572-4621
- **Phone:** (843) 895-2120
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 4 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (3), Obstetrics/Gynecology (1); 2 practice at this address and 3 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 25, 2023
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1669188538) · Data from the CMS NPPES public registry.