NPIMap

Organization Active NPI

East Cooper Physician Group LLC

Doing business as Novant Health Mullis Internal Medicine

  • Family Medicine Physician
  • Mount Pleasant, SC
National Provider Identifier
1679334700
Registry record updated Feb 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
EAST COOPER PHYSICIAN GROUP LLC
Doing business as
Novant Health Mullis Internal Medicine
Practice address
851 Leonard Fulghum Dr Ste 100
Mt Pleasant, SC 29464-3793
Phone
(843) 884-2133
Fax
(843) 884-2868
NPI assigned
Jan 16, 2024
Last updated
Feb 28, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2026

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

Authorized official

Name
Leea Jeanine Walton
Title
RCS Manger
Phone
(336) 515-7085

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

851 Leonard Fulghum Dr Ste 100
Mt Pleasant, SC 29464-3793

Mailing address

PO Box 604408
Charlotte, NC 28260-4408

Other names 1

  • Novant Health Mullis Internal Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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…

Other NPIs on the same Medicare enrollment 31

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

View all 31

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D1104835Novant Health Mullis Internal Medicine851 Leonard Fulghum Blvd, Suite 100, Mount Pleasant, SC 29464Certificate of waiverJun 19, 2027

National Provider Directory

National Provider Directory
Tax ID family
East Cooper Physician Group LLC49 organizations share this tax ID, including this one

Other organizations with this tax ID 48

Organizations that report the same tax identification number in the National Provider Directory.

View all 48

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1705363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772236800000",
    "number": "1679334700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 604408",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282604408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 LEONARD FULGHUM DR STE 100",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294643793",
            "telephone_number": "843-884-2133",
            "fax_number": "843-884-2868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST COOPER PHYSICIAN GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-16",
        "last_updated": "2026-02-28",
        "certification_date": "2026-02-28",
        "status": "A",
        "authorized_official_last_name": "WALTON",
        "authorized_official_first_name": "LEEA",
        "authorized_official_middle_name": "JEANINE",
        "authorized_official_title_or_position": "RCS MANGER",
        "authorized_official_telephone_number": "336-515-7085"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Mullis Internal Medicine",
            "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 Feb 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.