East Cooper Physician Group LLC
Organization Active NPI Orthopaedic Surgery Physician · Mt Pleasant, SC
NPI 1508637208 · NPPES record last updated Jan 22, 2024
Key facts
- NPI
- 1508637208
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- Legal business name
- EAST COOPER PHYSICIAN GROUP LLC
- Practice address
- 851 Leonard Fulghum Dr Ste 101
Mt Pleasant, SC 29464-3793 - Phone
- (843) 971-9350
- 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
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician |
207X00000X | Yes |
Addresses
Primary practice location
851 Leonard Fulghum Dr Ste 101
Mt Pleasant, SC 29464-3793
Mailing address
PO Box 37642
Belfast, ME 04915-1218
Other practice location 1
7 S Alliance Dr Ste 111B
Goose Creek, SC 29445-7296
Phone (843) 971-9350
Other names
- Charleston Institute for Advanced Orthopedics (CIAO)
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 · Orthopaedic Surgery 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 Jan 22, 2024. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.