NPIMap

Organization Active NPI

Roper Saint Francis Physicians Network

Doing business as Vascular Medicine and Wound Management Clinic

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Summerville, SC
National Provider Identifier
1194582841
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianTaxonomy code 2083P0011X
Legal business name
ROPER SAINT FRANCIS PHYSICIANS NETWORK
Doing business as
Vascular Medicine and Wound Management Clinic
Practice address
300 Callen Blvd Ste 220
Summerville, SC 29486-2816
Phone
(843) 724-2289
Fax
(843) 606-8038
NPI assigned
Feb 29, 2024
Last updated
Mar 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2024

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

Authorized official

Name
Robert OliverioNPI 1457373318
Title
VP
Phone
(843) 266-4400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2083P0011X Primary

Addresses

Primary practice location

300 Callen Blvd Ste 220
Summerville, SC 29486-2816

Mailing address

PO Box 751649
Charlotte, NC 28275-1649
Phone (888) 472-0043

Other names 1

  • Vascular Medicine and Wound Management Clinic Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090528000405 SC Part B Supplier - Clinic/Group Practice 5193874824 Receives reassigned benefits from 837 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Cardiothoracic Surgery of Charleston235 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

300 Callen Blvd
Ste 220
Summerville, SC 29486
Phone (843) 720-8317

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1709164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710720000000",
    "number": "1194582841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751649",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751649",
            "telephone_number": "888-472-0043",
            "fax_number": "843-724-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CALLEN BLVD STE 220",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294862816",
            "telephone_number": "843-724-2289",
            "fax_number": "843-606-8038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROPER SAINT FRANCIS PHYSICIANS NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-29",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-14",
        "status": "A",
        "authorized_official_last_name": "OLIVERIO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "843-266-4400"
    },
    "taxonomies": [
        {
            "code": "2083P0011X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd Ste 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Vascular Medicine and Wound Management Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vascular Medicine and Wound Management Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Summerville, SC

Sources for this page

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