OrganizationActive
Grand Strand Pediatrics & Adolescent Medicine, P.A.
NPI 1588614192 · Pediatric Adolescent Medicine Physician · Myrtle Beach, SC
Provider details
- NPI number
- 1588614192
- Entity type
- Organization
- Primary specialty
- Pediatric Adolescent Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Thomas Petrusick, Owner/Physician(843) 449-1438
- License
- 7085 (SC)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
8120 Rourk St
Myrtle Beach, SC 29572-4127
Phone: (843) 449-1438
Fax: (843) 286-1349
Street-level locationGet directions
Mailing address
8120 Rourk St
Myrtle Beach, SC 29572-4127
Registry dates
- Enumerated
- 2006-05-12
- Last updated
- 2014-02-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.