Organization Active NPI

SC Cardiovascular Associates LLC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Mount Pleasant, SC
National Provider Identifier
1508927591
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
12973 Issued in SC
Legal business name
SC CARDIOVASCULAR ASSOCIATES LLC
Practice address
1156 Bowman Rd Unit 103
Mount Pleasant, SC 29464-3803
Phone
(843) 654-7337
NPI assigned
Dec 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Authorized official

Name
Michael Lamar Edwards, MDNPI 1649331729
Title
Owner
Phone
(843) 654-7337

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208G00000X 12973 SC Primary

Addresses

Primary practice location

1156 Bowman Rd Unit 103
Mount Pleasant, SC 29464-3803

Mailing address

102 Ashley Ave Apt a
Charleston, SC 29401-6206
Phone (843) 654-7337

Other practice location 1

2000 Hospital Dr
Mount Pleasant, SC 29464-3764
Phone (843) 654-7337

Other identifiers 1

IdentifierTypeStateIssuer
GP3500MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120419000268 SC Part B Supplier - Clinic/Group Practice 9537320544 Receives reassigned benefits from 1 practitioner
Practice locations: Mount Pleasant, SC

National Provider Directory

National Provider Directory

Locations

2791 Tricom St
Ste 101
North Charleston, SC 29406
Phone (843) 572-2100

9213 University Blvd
Ste C
North Charleston, SC 29406
Phone (843) 572-2100

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742515200000",
    "number": "1508927591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 ASHLEY AVE APT A",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294016206",
            "telephone_number": "843-654-7337",
            "fax_number": "843-654-7336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1156 BOWMAN RD UNIT 103",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294643803",
            "telephone_number": "843-654-7337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "SC",
            "postal_code": "294643764",
            "country_code": "US",
            "telephone_number": "843-654-7337",
            "fax_number": "843-654-7336",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SC CARDIOVASCULAR ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "LAMAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-654-7337",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "SC",
            "license": "12973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3500",
            "state": "SC"
        }
    ],
    "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 Mar 21, 2025; 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.