Active NPI
South Carolina Group Services, LLC
- Hospitalist Physician
- Mount Pleasant, SC
National Provider Identifier
1609212232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- Legal business name
- SOUTH CAROLINA GROUP SERVICES, LLC
- Practice address
- 2000 Hospital Dr
Mount Pleasant, SC 29464-3764 - Phone
- (770) 874-5439
- Fax
- (770) 874-5483
- NPI assigned
- May 22, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kim H Larsen
- Title
- Director of Credentialing
- Phone
- (770) 874-5400
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | Primary |
Addresses
Primary practice location
2000 Hospital Dr
Mount Pleasant, SC 29464-3764
Mailing address
PO Box 21330
Belfast, ME 04915-4110
Phone (770) 874-5400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130912000800 | SC | Part B Supplier - Clinic/Group Practice | 1759525777 |
Receives reassigned benefits from 72 practitioners Practice locations: Mount Pleasant, SC |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 75
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": "1369180800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1580860800000",
"number": "1609212232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 21330",
"city": "BELFAST",
"state": "ME",
"postal_code": "049154110",
"telephone_number": "770-874-5400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 HOSPITAL DR",
"city": "MOUNT PLEASANT",
"state": "SC",
"postal_code": "294643764",
"telephone_number": "770-874-5439",
"fax_number": "770-874-5483"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUTH CAROLINA GROUP SERVICES, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2013-05-22",
"last_updated": "2020-02-05",
"certification_date": "2020-02-05",
"status": "A",
"authorized_official_last_name": "LARSEN",
"authorized_official_first_name": "KIM",
"authorized_official_middle_name": "H",
"authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING",
"authorized_official_telephone_number": "770-874-5400"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Hospitalist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Pleasant, SC
- South Carolina CVS Pharmacy LLC
- South Carolina CVS Pharmacy LLC
- South Carolina CVS Pharmacy, L.L.C.
- South Carolina CVS Pharmacy, L.L.C.
- South Carolina Diagnostic Imaging
- South Carolina Radiology Group, LLC
- South Carolina Sewee Family Medicine, LLC
- Sarah E Southall, PT
- Southeastern Fertility Center II, PA
- Southeastern Fertility Center PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2020; 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.