NPIMap

Organization Active NPI

East Cooper Physician Group LLC

Doing business as The Comprehensive Wound Center

  • Surgery Physician
  • Mount Pleasant, SC
National Provider Identifier
1285495234
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
EAST COOPER PHYSICIAN GROUP LLC
Doing business as
The Comprehensive Wound Center
Practice address
1156 Bowman Rd Unit 103
Mt Pleasant, SC 29464-3803
Phone
(000) 000-0000
NPI assigned
Jan 17, 2024
Last updated
Jan 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Authorized official

Name
Doreatha Rogers
Title
RCS Manager
Phone
(980) 302-7992

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

1156 Bowman Rd Unit 103
Mt Pleasant, SC 29464-3803

Mailing address

PO Box 37642
Belfast, ME 04915-1218

Other names 1

  • The Comprehensive Wound Center 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

Practitioners & affiliated clinicians

Practitioners 4

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": "1705449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706140800000",
    "number": "1285495234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37642",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049151218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1156 BOWMAN RD UNIT 103",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294643803",
            "telephone_number": "000-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST COOPER PHYSICIAN GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-17",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-24",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "DOREATHA",
        "authorized_official_title_or_position": "RCS MANAGER",
        "authorized_official_telephone_number": "980-302-7992"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Comprehensive Wound Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Comprehensive Wound Center",
            "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 Jan 25, 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.