NPIMap

Organization Active NPI

PPCP Specialty Physicians , LLC

  • Gastroenterology Physician
  • Charleston, SC
National Provider Identifier
1093585044
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
PPCP SPECIALTY PHYSICIANS , LLC
Practice address
9313 Medical Plaza Dr Ste 202
Charleston, SC 29406-9176
Phone
(843) 572-1200
NPI assigned
Jan 2, 2024
Last updated
Jan 2, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
PPCP SPECIALTY PHYSICIANS , LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jolinda L Phillips
Title
Sr Analyst of Revenue Cycle
Phone
(843) 572-7727

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X NU Primary

Addresses

Primary practice location

9313 Medical Plaza Dr Ste 202
Charleston, SC 29406-9176

Mailing address

PO Box 530062
Atlanta, GA 30353-0062
Phone (843) 572-7727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170801001865 SC Part B Supplier - Clinic/Group Practice 2466723028 Receives reassigned benefits from 32 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Charleston, SC; Summerville, SC; Mt Pleasant, SC; Moncks Corner, SC; Ladson, SC; Irmo, SC; Goose Creek, SC; Daniel Island, SC…

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory
Tax ID family
PPCP Specialty Physicians10 organizations share this tax ID, including this one
Part of
PPCP Specialty Physicians

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

7 S Alliance Dr
Ste 202A
Goose Creek, SC 29445
Phone (843) 376-6070

730 Stony Landing Rd
Ste 200
Moncks Corner, SC 29461
Phone (843) 567-3206

9313 Medical Plaza Dr
Ste 202
North Charleston, SC 29406
Phone (843) 572-1200

5500 Front St
Ste 230
Summerville, SC 29486
Phone (843) 569-1856

Practitioners & affiliated clinicians

Practitioners 32

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 32

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1704153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704153600000",
    "number": "1093585044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 530062",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303530062",
            "telephone_number": "843-572-7727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9313 MEDICAL PLAZA DR STE 202",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294069176",
            "telephone_number": "843-572-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PPCP SPECIALTY PHYSICIANS , LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PPCP SPECIALTY PHYSICIANS , LLC",
        "enumeration_date": "2024-01-02",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "JOLINDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SR ANALYST OF REVENUE CYCLE",
        "authorized_official_telephone_number": "843-572-7727"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.