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SOUTHERN SHORES UROGYNECOLOGY AND PELVIC RECONSTRUCTIVE SURGERY PC
NPI 1669188538
Obstetrics & Gynecology - Urogynecology and Reconstructive Pelvic Surgery in Myrtle Beach, SC

Active since January 25, 2023CLIA 42D2274675 · Waiver
1021 CIPRIANA DR STE 250, MYRTLE BEACH, SC 29572(843) 895-2120 Get Directions Write a Review

NPPES record last updated: January 25, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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

NPI1669188538
Entity TypeOrganization
Primary Taxonomy207VF0040X
Legal Business NameSOUTHERN SHORES UROGYNECOLOGY AND PELVIC RECONSTRUCTIVE SURGERY PC
Location Address1021 CIPRIANA DR STE 250Myrtle Beach, SC 29572-4621
Mailing Address1021 Cipriana Dr Ste 250Myrtle Beach, SC 29572-4621
Phone(843) 895-2120
Organization SubpartNo
Authorized OfficialJanet E Harris-hicksOwner · (843) 895-2120
Enumeration DateJanuary 25, 2023
NPPES CertifiedJanuary 25, 2023
✔ NPI 1669188538 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & Gynecology · Urogynecology and Reconstructive Pelvic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207VF0040X
Definition
A subspecialist in Urogynecology and Reconstructive Pelvic Surgery is a physician in Urology or Obstetrics and Gynecology who, by virtue of education and training, is prepared to provide consultation and comprehensive management of women with complex benign pelvic conditions, lower urinary tract disorders, and pelvic floor dysfunction. Comprehensive management includes those diagnostic and therapeutic procedures necessary for the total care of the patient with these conditions and complications resulting from them.
1021 CIPRIANA DR STE 250, Myrtle Beach, SC 29572
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina and more.Insurance ›

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, SC
Active · expires Jan 8, 2027
CLIA Number42D2274675
Laboratory TypePhysician Office
Certificate Effective DateJanuary 9, 2025
Certificate Expiration DateJanuary 8, 2027
Laboratory DirectorDr. Janet E. Harris-Hicks
Laboratory Phone(910) 280-2524
Laboratory LocationSouthern Shores Urogynecology1021 Cipriana Drive, Suite 250, Myrtle Beach, SC 29572
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

SAMANTHA BROWN
Physician Assistant
1021 CIPRIANA DR STE 250
MYRTLE BEACH, SC 29572
Horry County (563) 333-5827
JANET E HARRIS-HICKS M.D.
Obstetrics & Gynecology (Urogynecology and Reconstructive Pelvic Surgery)
1021 CIPRIANA DR STE 250
MYRTLE BEACH, SC 29572
Horry County (910) 330-9080
JILLIAN ABIGAIL BENTON FNP-BC
Nurse Practitioner
1021 CIPRIANA DR STE 250
MYRTLE BEACH, SC 29572
Horry County (843) 895-2120

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 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.

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 Ambetter from Absolute Total Care, Ambetter of North Carolina, 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 with the weekly NPPES data releases published by CMS.