NPIMap

Organization Active NPI

East Cooper Coastal Family Physicians

  • Physician Assistant
  • Mount Pleasant, SC
National Provider Identifier
1366797375
Registry record updated Jul 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
TL1798 Issued in SC
Legal business name
EAST COOPER COASTAL FAMILY PHYSICIANS
Practice address
1200 Two Island Court Suite E
Mt Pleasant, SC 29464
Phone
(843) 849-1300
NPI assigned
Jul 16, 2012
Last updated
Jul 16, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2012

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

Authorized official

Name
Nichole Olson
Title
Practice Manager
Phone
(843) 849-1300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X TL1798 SC Primary

Addresses

Primary practice location

1200 Two Island Court Suite E
Mt Pleasant, SC 29464

Mailing address

1200 Two Island Court Suite E
Mt Pleasant, SC 29464

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1342396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342396800000",
    "number": "1366797375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 TWO ISLAND COURT SUITE E",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "29464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 TWO ISLAND COURT SUITE E",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "29464",
            "telephone_number": "843-849-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST COOPER COASTAL FAMILY PHYSICIANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-16",
        "last_updated": "2012-07-16",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "NICHOLE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "843-849-1300"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "TL1798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.