NPIMap

Organization Active NPI

Roper St. Francis Mount Pleasant Hospital

Doing business as Mount Pleasant Hospital ER

  • Emergency Medicine Physician
  • Mount Pleasant, SC
National Provider Identifier
1649587270
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
ROPER ST. FRANCIS MOUNT PLEASANT HOSPITAL
Doing business as
Mount Pleasant Hospital ER
Practice address
3500 Highway 17 N
Mount Pleasant, SC 29466
Phone
(843) 724-2954
Fax
(843) 881-3070
NPI assigned
Sep 2, 2010
Last updated
Nov 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Authorized official

Name
Mr. William Anthony Jackson
Title
Chief Executive Officer
Phone
(843) 724-2954

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X SC Primary

Addresses

Primary practice location

3500 Highway 17 N
Mount Pleasant, SC 29466

Mailing address

3500 Highway 17 N
Suite 200
Mount Pleasant, SC 29466-9123
Phone (843) 724-2954

Other names 1

  • Mount Pleasant Hospital ER Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110207000316 SC Part B Supplier - Clinic/Group Practice 1658567326 Receives reassigned benefits from 161 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mt Pleasant, SC; Mt. Pleasant, SC

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 93

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 93

NPI Registry JSON

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

{
    "created_epoch": "1283385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1649587270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 HIGHWAY 17 N",
            "address_2": "SUITE 200",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294669123",
            "telephone_number": "843-724-2954",
            "fax_number": "843-881-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 HIGHWAY 17 N",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "29466",
            "telephone_number": "843-724-2954",
            "fax_number": "843-881-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROPER ST. FRANCIS MOUNT PLEASANT HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-02",
        "last_updated": "2023-11-27",
        "certification_date": "2020-02-04",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "843-724-2954",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Mount Pleasant Hospital ER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 27, 2023; 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.