East Cooper Physician Group LLC

Organization Active NPI Obstetrics & Gynecology Physician · Daniel Island, SC

NPI 1316708449 · NPPES record last updated Feb 28, 2026

Key facts

NPI
1316708449
Entity type
Organization (NPI type 2)
Primary specialty
Obstetrics & Gynecology Physician 207V00000X
Legal business name
EAST COOPER PHYSICIAN GROUP LLC
Practice address
880 Island Park Dr Unit 210
Daniel Island, SC 29492-2902
Phone
(843) 884-5133
Fax
(843) 849-3343
NPI assigned
Jan 16, 2024
Organization subpart
No

Authorized official

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

Other NPIs on the same Medicare enrollment 31

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

View all 31

Corporate family (same tax ID) 48

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

View all 48

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D2163189Novant Health Lowcountry OB/GYN
880 Island Park Drive, Daniel Island, SC 29492
Certificate of waiverMar 7, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled in SC

Medicare enrollment records

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…

National Provider Directory

Tax ID family
East Cooper Physician Group LLC (49 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207V00000X Yes

Addresses

Primary practice location

880 Island Park Dr Unit 210
Daniel Island, SC 29492-2902

Mailing address

PO Box 604408
Charlotte, NC 28260-4408

Other names

  • Lowcountry OB/GYN Doing business as
  • Novant Health Lowcountry OB/GYN Doing business as

Other providers in Daniel Island, SC

All providers in Daniel Island, SC · Obstetrics & Gynecology Physician in South Carolina

Sources for this page

Verify at the official NPI Registry.