NPIMap

Organization Active NPI

South Carolina Group Services, LLC

  • Hospitalist Physician
  • Mount Pleasant, SC
National Provider Identifier
1609212232
Registry record updated Feb 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
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
Last updated
Feb 5, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2020

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)CodeLicenseStatePrimary
Hospitalist PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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 IDStateProvider typePAC IDDetails
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 Directory

Practitioners & affiliated clinicians

Practitioners 75

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.

View all 75

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

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.

Verify at the official NPI Registry.