NPIMap

Organization Active NPI

East Cooper Physician Group LLC

Doing business as Novant Health Interventional Imaging at East Cooper

  • Diagnostic Radiology Physician
  • Mount Pleasant, SC
National Provider Identifier
1114893096
Registry record updated Sep 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
EAST COOPER PHYSICIAN GROUP LLC
Doing business as
Novant Health Interventional Imaging at East Cooper
Practice address
2000 Hospital Dr
Mt Pleasant, SC 29464-3764
Phone
(843) 416-6150
Fax
(843) 380-8212
NPI assigned
Oct 16, 2025
Last updated
Sep 18, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2026

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

Authorized official

Name
Leea Jeanine Walton
Title
RCS Manager
Phone
(704) 316-6081

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X NU Primary

Addresses

Primary practice location

2000 Hospital Dr
Mt Pleasant, SC 29464-3764

Mailing address

PO Box 604408
Charlotte, NC 28260-4408

Other practice location 1

103 Gardiners Bay Dr
Ponte Vedra, FL 32081-4406
Phone (843) 881-0100

Other practice location 2

651 Old Bluff Dr
Ponte Vedra, FL 32081-0718
Phone (843) 881-0100

Other practice location 3

24609 Deer Trace Dr
Ponte Vedra Beach, FL 32082-2114
Phone (843) 881-0100

Other names 1

  • Novant Health Interventional Imaging at East Cooper Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240214000176 SC Part B Supplier - Clinic/Group Practice 1254775687 Receives reassigned benefits from 173 practitioners
31 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Goose Creek, SC; Summerville, SC; North Augusta, SC; Mt Pleasant, SC; Mount Pleasant, SC; Beaufort, SC; Georgetown, SC; Fort Mill, SC…

Other NPIs on the same Medicare enrollment 31

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

View all 31

National Provider Directory

National Provider Directory
Tax ID family
East Cooper Physician Group LLC49 organizations share this tax ID, including this one

Other organizations with this tax ID 48

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

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1760572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789689600000",
    "number": "1114893096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 604408",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282604408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 HOSPITAL DR",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294643764",
            "telephone_number": "843-416-6150",
            "fax_number": "843-380-8212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 GARDINERS BAY DR",
            "address_purpose": "LOCATION",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320814406",
            "country_code": "US",
            "telephone_number": "843-881-0100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "651 OLD BLUFF DR",
            "address_purpose": "LOCATION",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320810718",
            "country_code": "US",
            "telephone_number": "843-881-0100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24609 DEER TRACE DR",
            "address_purpose": "LOCATION",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320822114",
            "country_code": "US",
            "telephone_number": "843-881-0100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EAST COOPER PHYSICIAN GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-16",
        "last_updated": "2026-09-18",
        "certification_date": "2026-09-18",
        "status": "A",
        "authorized_official_last_name": "WALTON",
        "authorized_official_first_name": "LEEA",
        "authorized_official_middle_name": "JEANINE",
        "authorized_official_title_or_position": "RCS MANAGER",
        "authorized_official_telephone_number": "704-316-6081"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Interventional Imaging at East Cooper",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2026; 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.