East Cooper Physician Group LLC
Organization Active NPI Obstetrics & Gynecology Physician · Mt Pleasant, SC
NPI 1386415099 · NPPES record last updated Feb 28, 2026
Key facts
- NPI
- 1386415099
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- Legal business name
- EAST COOPER PHYSICIAN GROUP LLC
- Practice address
- 1625 Hospital Dr Ste 370
Mt Pleasant, SC 29464-5293 - Phone
- (843) 883-1007
- Fax
- (843) 883-1016
- NPI assigned
- Jan 11, 2024
- Organization subpart
- No
Authorized official
- Name
- Doreatha Rogers
- Title
- RCS Manager
- Phone
- (980) 302-7992
Other NPIs on the same Medicare enrollment 31
Corporate family (same tax ID) 48
Practitioners 1
-
Emily S Shelley, P.A.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 42D2180529 | Novant Health East Cooper Maternal- Fetal | Provider-performed microscopy | Mar 16, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
Locations
880 Island Park Dr
Unit 210
Daniel Island, SC 29492
Phone (843) 883-1007
2199 N Fraser St
Ste B
Georgetown, SC 29440
Phone (843) 883-1007
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician |
207V00000X | Yes |
Addresses
Primary practice location
1625 Hospital Dr Ste 370
Mt Pleasant, SC 29464-5293
Mailing address
PO Box 604408
Charlotte, NC 28260-4408
Other practice location 1
2199 N Fraser St Ste B
Georgetown, SC 29440-6409
Phone (843) 883-1007
Other practice location 2
880 Island Park Dr Unit 210
Daniel Island, SC 29492-2902
Phone (843) 883-1007
Other names
- East Cooper Maternal Fetal Medicine Specialists
- Novant Health East Cooper Maternal-Fetal Medicine
Other providers in Mt Pleasant, SC
- East Cooper Physician Group LLC
- East Cooper Physician Group LLC
- East Cooper Physician Group LLC
- East Cooper Physician Group LLC
- East Cooper Physician Group LLC
- East Cooper Physician Group LLC
- East Cooper Physician Group LLC
- East Cooper Physician Group LLC
- East Cooper Physician Group LLC
- East Cooper Physician Group LLC
All providers in Mt Pleasant, SC · Obstetrics & Gynecology Physician in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 28, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.