NPIMap

Organization Active NPI

Roper Saint Francis Physicians Network

Doing business as Roper St. Francis Physician Partners Obesity Medicine

  • Obesity Medicine (Preventive Medicine) Physician
  • Moncks Corner, SC
National Provider Identifier
1376155366
Registry record updated Mar 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obesity Medicine (Preventive Medicine) PhysicianTaxonomy code 2083B0002X
Legal business name
ROPER SAINT FRANCIS PHYSICIANS NETWORK
Doing business as
Roper St. Francis Physician Partners Obesity Medicine
Practice address
3508 S Live Oak Dr
Moncks Corner, SC 29461-8737
Phone
(843) 212-8022
Fax
(843) 402-1972
NPI assigned
Aug 20, 2020
Last updated
Mar 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2024

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

Authorized official

Name
Robert OliverioNPI 1457373318
Title
Ceo
Phone
(843) 789-9319

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
Obesity Medicine (Preventive Medicine) Physician 2083B0002X Primary

Addresses

Primary practice location

3508 S Live Oak Dr
Moncks Corner, SC 29461-8737

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
GP9755MedicaidSC

Other names 1

  • Roper St. Francis Physician Partners Obesity Medicine 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
Roper St Francis Phy Netwk235 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

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": "1597881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710633600000",
    "number": "1376155366",
    "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": "3508 S LIVE OAK DR",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294618737",
            "telephone_number": "843-212-8022",
            "fax_number": "843-402-1972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROPER SAINT FRANCIS PHYSICIANS NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-20",
        "last_updated": "2024-03-17",
        "certification_date": "2024-03-17",
        "status": "A",
        "authorized_official_last_name": "OLIVERIO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "843-789-9319"
    },
    "taxonomies": [
        {
            "code": "2083B0002X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Obesity Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP9755",
            "state": "SC"
        }
    ],
    "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 # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Roper St. Francis Physician Partners Obesity Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Roper St. Francis Physician Partners Obesity Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Moncks Corner, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.