Active NPI
Senior Doc South Carolina PC
- Family Medicine Physician
- Summerville, SC
National Provider Identifier
1184501314
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- SENIOR DOC SOUTH CAROLINA PC
- Practice address
- 700 Nexton Square Dr
Summerville, SC 29486-7915 - Phone
- (855) 434-7763
- NPI assigned
- Aug 19, 2025
- Last updated
- Aug 19, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- John Mark Geiss, D.O.
- Title
- Ceo
- Phone
- (714) 702-5145
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
700 Nexton Square Dr
Summerville, SC 29486-7915
Mailing address
5 Hutton Centre Dr Ste 950
Santa Ana, CA 92707-8744
Phone (855) 434-7763
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
700 Nexton Square Dr
Ste 410
Summerville, SC 29486
Practitioners & affiliated clinicians
Practitioners 5
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.
-
- Physician Assistant
- Ridgefield, CT
- NPI 1386897262
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1755561600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1755561600000",
"number": "1184501314",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 HUTTON CENTRE DR STE 950",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927078744",
"telephone_number": "855-434-7763"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 NEXTON SQUARE DR",
"city": "SUMMERVILLE",
"state": "SC",
"postal_code": "294867915",
"telephone_number": "855-434-7763"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SENIOR DOC SOUTH CAROLINA PC",
"organizational_subpart": "NO",
"enumeration_date": "2025-08-19",
"last_updated": "2025-08-19",
"certification_date": "2025-08-19",
"status": "A",
"authorized_official_last_name": "GEISS",
"authorized_official_first_name": "JOHN",
"authorized_official_middle_name": "MARK",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "714-702-5145",
"authorized_official_credential": "D.O."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Summerville, SC
- Second Wind Life Services, LLC
- Hazel Gramling Segelken, CPNP
- Sabrina Seler
- Eric Robert Selinsky, DPT
- Tharakeswari Selvakumar, MD, PHD
- Senior Therapy Solutions, LLC (Senior Therapy Solutions SC)
- Serenity Begins Within
- Serenity Solutions Counseling and Consulting (Wendy Fredrickson Trudeau, LISW-CP)
- Orlin Sergev, M.D., PH.D.
- Joseph Michael Serra, DDS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2025; 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.