Active NPI
East Cooper Physician Group LLC
Doing business as Novant Health Diagnostic Imaging at East Cooper
- Body Imaging Physician
- Mount Pleasant, SC
National Provider Identifier
1699641571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Body Imaging Physician
- Legal business name
- EAST COOPER PHYSICIAN GROUP LLC
- Doing business as
- Novant Health Diagnostic Imaging at East Cooper
- Practice address
- 2000 Hospital Dr
Mt Pleasant, SC 29464-3764 - Phone
- (843) 881-0110
- Fax
- (843) 380-8212
- NPI assigned
- Oct 16, 2025
- Last updated
- Sep 18, 2026
- 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
- Leea Jeanine Walton
- Title
- RCS Manager
- Phone
- (704) 316-6081
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Body Imaging Physician | 2085B0100X | NU | Primary |
Addresses
Primary practice location
2000 Hospital Dr
Mt Pleasant, SC 29464-3764
Mailing address
PO Box 604408
Charlotte, NC 28260-4408
Other practice location 1
647 Ocean Shore Blvd
Ormond Beach, FL 32176-4701
Phone (843) 881-0100
Other practice location 2
7200 Holywell LN
Falls Church, VA 22043-3081
Phone (843) 881-0100
Other practice location 3
20 Acclaim at Lionspaw
Daytona Beach, FL 32124-1512
Phone (843) 881-0100
Other practice location 4
Urb Asomante 21 Via Guajana # 523
Caguas, PR 00727-3057
Phone (843) 881-0100
Other practice location 5
6118 SW 72ND Ter
Ocala, FL 34474-9750
Phone (843) 881-0100
Other practice location 6
1485 Ave. Ashfort Cond. St. Mary's Plaza Torre Norte,
Apt 12a
San Juan, PR 00907-1597
Phone (843) 881-0100
Other practice location 7
3585 SW 38th Ter
Ocala, FL 34474-5808
Phone (843) 881-0100
Other practice location 8
1620 SW 55TH Street Rd
Ocala, FL 34471-0134
Phone (843) 881-0100
Other practice location 9
6061 SW 13TH St
West Miami, FL 33144-5720
Phone (843) 881-0100
Other practice location 10
5455 SW 28TH Ave
Ocala, FL 34471-9549
Phone (843) 881-0100
Other practice location 11
3038 SW 41St LN
Ocala, FL 34474-5860
Phone (843) 881-0100
Other practice location 12
1418 Lake Daniel Dr
Orlando, FL 32804-3420
Phone (843) 881-0100
Other practice location 13
7302 SE 12TH Cir
Ocala, FL 34480-6650
Phone (843) 881-0100
Other practice location 14
3877 SE 5TH Ave
Ocala, FL 34480-2703
Phone (843) 881-0100
Other practice location 15
162 Laurelwood LN
Ormond Beach, FL 32174-4227
Phone (843) 881-0100
Other practice location 16
Urb Montehiedra 238 Calle Jilguero
San Juan, PR 00926-7107
Phone (843) 881-0100
Other practice location 17
3100 Saint Johns Dr
Dallas, TX 75205-2938
Phone (843) 881-0100
Other practice location 18
87 S Riverwalk Dr
Palm Coast, FL 32137-1318
Phone (843) 881-0100
Other practice location 19
1500 SW 5TH St
Fort Lauderdale, FL 33312-7507
Phone (843) 881-0100
Other practice location 20
437 Triton Rd
Ormond Beach, FL 32176-5459
Phone (843) 881-0100
Other practice location 21
1122 SE 46TH St
Ocala, FL 34480-4734
Phone (843) 881-0100
Other practice location 22
608 John Anderson Dr
Ormond Beach, FL 32176-4763
Phone (843) 881-0100
Other practice location 23
3879 SE 6TH Ave
Ocala, FL 34480-4794
Phone (843) 881-0100
Other practice location 24
31 Hunter Ridge Rd
Monroe, CT 06468-2447
Phone (843) 881-0100
Other practice location 25
4420 SE 48TH Place Rd
Ocala, FL 34480-4906
Phone (843) 881-0100
Other practice location 26
1194 SW 37TH Place Rd
Ocala, FL 34471-7232
Phone (843) 881-0100
Other practice location 27
1111 Rosland Cir
Augusta, GA 30909-9846
Phone (843) 881-0100
Other practice location 28
1320 Kainui Dr
Kailua, HI 96734-1935
Phone (843) 881-0100
Other practice location 29
5 Washington St Apt 318
Brighton, MA 02135-7457
Phone (843) 881-0100
Other practice location 30
1048 SE 69TH PL
Ocala, FL 34480-6642
Phone (843) 881-0100
Other practice location 31
25 River Ridge TRL
Ormond Beach, FL 32174-4341
Phone (843) 881-0100
Other practice location 32
1507 Oak Forest Dr
Ormond Beach, FL 32174-3409
Phone (843) 881-0100
Other practice location 33
4820 SW 48th Ave Unit 305
Ocala, FL 34474-6303
Phone (843) 881-0100
Other practice location 34
15517 Shorebird LN
Winter Garden, FL 34787-4379
Phone (843) 881-0100
Other practice location 35
213 SE 15TH Ave
Ocala, FL 34471-2438
Phone (843) 881-0100
Other practice location 36
1352 SE 42ND Rd
Ocala, FL 34480-2769
Phone (843) 881-0100
Other practice location 37
4363 S Atlantic Ave
Ponce Inlet, FL 32127-6941
Phone (843) 881-0100
Other practice location 38
10 Calle M Rivera Ferrer
Guaynabo, PR 00968-4611
Phone (843) 881-0100
Other practice location 39
1920 W Granada Blvd
Ormond Beach, FL 32174-6739
Phone (843) 881-0100
Other practice location 40
387 Leoni St
New Smyrna Beach, FL 32168-4525
Phone (843) 881-0100
Other practice location 41
129 Arnau CT
St Augustine, FL 32095-8873
Phone (843) 881-0100
Other practice location 42
1920 W Granada Blvd
Ormond Beach, FL 32174-6739
Phone (843) 881-0100
Other practice location 43
3707 Burnt Pine Dr
Jacksonville, FL 32224-0855
Phone (843) 881-0100
Other practice location 44
185 Heatherton Way
Winston Salem, NC 27104-4445
Phone (843) 881-0100
Other practice location 45
2315 SE 24TH Ave
Ocala, FL 34471-8356
Phone (843) 881-0100
Other practice location 46
56 Foxcroft Run
Ormond Beach, FL 32174-2475
Phone (843) 881-0100
Other practice location 47
244 Horton Grove Rd
Fort Mill, SC 29715-7845
Phone (843) 881-0100
Other practice location 48
878 Creekwood Dr
Ormond Beach, FL 32174-1445
Phone (843) 881-0100
Other practice location 49
511 Ponce de Leon Ave
North Augusta, SC 29841-4166
Phone (843) 881-0100
Other practice location 50
4616 SE 12TH Ave
Ocala, FL 34480-4755
Phone (843) 881-0100
Other practice location 51
1181 Dixon Dr
Gainesville, GA 30501-2920
Phone (843) 881-0100
Other practice location 52
90 Lakeview Pass Way
Saint Johns, FL 32259-5961
Phone (843) 881-0100
Other practice location 53
202 Phillips PL
Orlando, FL 32806-1218
Phone (843) 881-0100
Other practice location 54
5601 SE Highway 42
Summerfield, FL 34491-5137
Phone (843) 881-0100
Other practice location 55
918 Dominion Hill Dr
Cary, NC 27519-9347
Phone (843) 881-0100
Other practice location 56
4507 Glen Kernan Pkwy E
Jacksonville, FL 32224-5628
Phone (843) 881-0100
Other practice location 57
16 Lyda Dr
Milford, CT 06460-3755
Phone (843) 881-0100
Other practice location 58
2805 SE 22ND Ave
Ocala, FL 34471-1017
Phone (843) 881-0100
Other practice location 59
1204 N Peninsula Ave
New Smyrna Beach, FL 32169-2226
Phone (843) 881-0100
Other practice location 60
2 Sheffield PL
Winston Salem, NC 27104-2046
Phone (843) 881-0100
Other practice location 61
12724 Westwood Lakes Blvd
Tampa, FL 33626-2345
Phone (843) 881-0100
Other practice location 62
190 Clearblue Loop
Summerville, SC 29486-5405
Phone (843) 881-0100
Other practice location 63
7091 SW 60TH LN
Ocala, FL 34474-1943
Phone (843) 881-0100
Other practice location 64
2337 Crimson King Dr
Braselton, GA 30517-4020
Phone (843) 881-0100
Other practice location 65
882 White Horse Dr
Greenville, NC 27834-7833
Phone (843) 881-0100
Other practice location 66
5335 Tildens Grove Blvd
Windermere, FL 34786-5706
Phone (843) 881-0100
Other practice location 67
120 Ave Chardon, Apt 1501 Sur
San Juan, PR 00918-1721
Phone (843) 881-0100
Other practice location 68
930 Wynhaven LN
Ballwin, MO 63011-2938
Phone (843) 881-0100
Other practice location 69
7254 SE 12TH Cir
Ocala, FL 34480-6650
Phone (843) 881-0100
Other practice location 70
5637 SW 50TH Ter
Ocala, FL 34474-4743
Phone (843) 881-0100
Other practice location 71
1209 SE 14TH St
Ocala, FL 34471-4523
Phone (843) 881-0100
Other practice location 72
1615 SE 7TH St
Ocala, FL 34471-4004
Phone (843) 881-0100
Other practice location 73
7627 SE 12TH Cir
Ocala, FL 34480-6648
Phone (843) 881-0100
Other practice location 74
6211 Grand Marina Cir
Gainesville, GA 30506-7805
Phone (843) 881-0100
Other practice location 75
5964 SW 73Rd Ter
Ocala, FL 34474-2036
Phone (843) 881-0100
Other names 1
- Novant Health Diagnostic Imaging at East Cooper
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC, TX, CT, GA, PR, NC, DC, MO, FL
Enrollment records 9
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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… |
| O20260303000708 | TX | Part B Supplier - Clinic/Group Practice | 1254775687 |
Receives reassigned benefits from 1 practitioner Practice locations: Dallas, TX |
| O20260304001626 | CT | Part B Supplier - Clinic/Group Practice | 1254775687 |
Receives reassigned benefits from 1 practitioner Practice locations: Monroe, CT; Milford, CT |
| O20260319004027 | GA | Part B Supplier - Clinic/Group Practice | 1254775687 |
Receives reassigned benefits from 1 practitioner Practice locations: Gainesville, GA; Braselton, GA; Augusta, GA |
| O20260319004341 | PR | Part B Supplier - Clinic/Group Practice | 1254775687 |
Receives reassigned benefits from 1 practitioner Practice locations: Caguas, PR; San Juan, PR; Guaynabo, PR |
| O20260323001771 | NC | Part B Supplier - Clinic/Group Practice | 1254775687 |
Receives reassigned benefits from 2 practitioners Practice locations: Cary, NC; Greenville, NC; Winston Salem, NC |
| O20260325003352 | DC | Part B Supplier - Clinic/Group Practice | 1254775687 |
Receives reassigned benefits from 1 practitioner Practice locations: Falls Church, VA |
| O20260326002784 | MO | Part B Supplier - Clinic/Group Practice | 1254775687 |
Receives reassigned benefits from 1 practitioner Practice locations: Ballwin, MO |
| O20260403002858 | FL | Part B Supplier - Clinic/Group Practice | 1254775687 |
Receives reassigned benefits from 14 practitioners Practice locations: Ocala, FL; Ormond Beach, FL; Orlando, FL; Palm Coast, FL; Ponce Inlet, FL; Saint Johns, FL; St Augustine, FL; Summerfield, FL… |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
- Internal Medicine Physician
- Daniel Island, SC
- NPI 1861253981
1254775687
Other NPIs on the same Medicare enrollment 31
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba Novant Health West Ashley Internal Medicine
- Internal Medicine Physician
- Charleston, SC
- NPI 1033006747
O20240214000176
-
dba Novant Health General Surgery & Bariatrics
- Surgery Physician
- Mount Pleasant, SC
- NPI 1043081755
O20240214000176
-
dba Novant Health Sewee Family Medicine
- Family Medicine Physician
- Mount Pleasant, SC
- NPI 1114798840
O20240214000176
-
dba Novant Health Interventional Imaging at East Cooper
- Diagnostic Radiology Physician
- Mount Pleasant, SC
- NPI 1114893096
O20240214000176
-
dba Novant Health Orthopedics & Sports Medicine
- Orthopaedic Surgery Physician
- Goose Creek, SC
- NPI 1174335491
O20240214000176
-
dba Hand Institute of Charleston
- Orthopaedic Surgery Physician
- Mount Pleasant, SC
- NPI 1205607926
O20240214000176
-
dba High Tide Internal Medicine - East Cooper Medical Group
- Internal Medicine Physician
- Daniel Island, SC
- NPI 1255192308
O20240214000176
-
- Sports Medicine (Orthopaedic Surgery) Physician
- Goose Creek, SC
- NPI 1255294989
O20240214000176
-
dba Novant Health General Surgery and Bariatrics
- Surgery Physician
- Beaufort, SC
- NPI 1275327850
O20240214000176
-
dba The Comprehensive Wound Center
- Surgery Physician
- Mount Pleasant, SC
- NPI 1285495234
O20240214000176
-
dba East Cooper Breast and General Surgery
- Surgery Physician
- Mount Pleasant, SC
- NPI 1285496026
O20240214000176
-
dba Lowcountry OB/GYN
- Obstetrics & Gynecology Physician
- Daniel Island, SC
- NPI 1316708449
O20240214000176
National Provider Directory
National Provider Directory- Tax ID family
- East Cooper Physician Group LLC
Other organizations with this tax ID 48
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Novant Health West Ashley Internal Medicine
- Internal Medicine Physician
- Charleston, SC
- NPI 1033006747
-
dba Novant Health General Surgery & Bariatrics
- Surgery Physician
- Mount Pleasant, SC
- NPI 1043081755
-
- Surgery Physician
- Mount Pleasant, SC
- NPI 1063246601
-
dba Hand Institute of Charleston East Cooper Medical Group
- Durable Medical Equipment & Medical Supplies
- Mount Pleasant, SC
- NPI 1093586885
-
dba Novant Health Sewee Family Medicine
- Family Medicine Physician
- Mount Pleasant, SC
- NPI 1114798840
-
dba Novant Health Interventional Imaging at East Cooper
- Diagnostic Radiology Physician
- Mount Pleasant, SC
- NPI 1114893096
-
dba Novant Health Orthopedics & Sports Medicine
- Orthopaedic Surgery Physician
- Goose Creek, SC
- NPI 1174335491
-
- Orthopaedic Surgery Physician
- Daniel Island, SC
- NPI 1194586685
-
dba Hand Institute of Charleston
- Orthopaedic Surgery Physician
- Mount Pleasant, SC
- NPI 1205607926
-
- Orthopaedic Surgery Physician
- Daniel Island, SC
- NPI 1235990722
-
dba High Tide Internal Medicine - East Cooper Medical Group
- Internal Medicine Physician
- Daniel Island, SC
- NPI 1255192308
-
- Sports Medicine (Orthopaedic Surgery) Physician
- Goose Creek, SC
- NPI 1255294989
Locations
3585 SW 38th Ter
Ocala, FL 34474
Phone (352) 355-0303
2199 N Fraser St
#B
Georgetown, SC 29440
Phone (843) 936-5951
2199 N Fraser St
Ste B
Georgetown, SC 29440
Phone (843) 883-1007
1625 Hospital Dr
Ste 360
Mt Pleasant, SC 29464
Phone (843) 936-5951
3400 Salterbeck St
Ste 100B
Mt Pleasant, SC 29466
Phone (843) 856-3262
851 Leonard Fulghum Dr
Ste 100
Mt Pleasant, SC 29464
Phone (843) 849-1300
Practitioners & affiliated clinicians
Practitioners 155
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.
-
- Vascular & Interventional Radiology Physician
- Ocala, FL
- NPI 1427176908
-
- Diagnostic Radiology Physician
- Ocala, FL
- NPI 1932197761
-
- Diagnostic Radiology Physician
- Miami, FL
- NPI 1548688708
-
- Vascular & Interventional Radiology Physician
- Ocala, FL
- NPI 1669664603
-
- Diagnostic Radiology Physician
- Ocala, FL
- NPI 1306043831
-
- Diagnostic Radiology Physician
- Ocala, FL
- NPI 1083602817
-
- Diagnostic Radiology Physician
- Jacksonville, FL
- NPI 1154522738
-
- Diagnostic Radiology Physician
- Gainesville, GA
- NPI 1922319599
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1760572800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1789689600000",
"number": "1699641571",
"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": "2000 HOSPITAL DR",
"city": "MT PLEASANT",
"state": "SC",
"postal_code": "294643764",
"telephone_number": "843-881-0110",
"fax_number": "843-380-8212"
}
],
"practiceLocations": [
{
"address_1": "647 OCEAN SHORE BLVD",
"address_purpose": "LOCATION",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "321764701",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "7200 HOLYWELL LN",
"address_purpose": "LOCATION",
"city": "FALLS CHURCH",
"state": "VA",
"postal_code": "220433081",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "20 ACCLAIM AT LIONSPAW",
"address_purpose": "LOCATION",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321241512",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "URB ASOMANTE 21 VIA GUAJANA # 523",
"address_purpose": "LOCATION",
"city": "CAGUAS",
"state": "PR",
"postal_code": "007273057",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "6118 SW 72ND TER",
"address_purpose": "LOCATION",
"city": "OCALA",
"state": "FL",
"postal_code": "344749750",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1485 Ave. Ashfort Cond. St. Mary's Plaza Torre Norte,",
"address_2": "Apt 12a",
"address_purpose": "LOCATION",
"city": "San Juan",
"state": "PR",
"postal_code": "009071597",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3585 SW 38th Ter",
"address_purpose": "LOCATION",
"city": "Ocala",
"state": "FL",
"postal_code": "344745808",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1620 SW 55TH STREET RD",
"address_purpose": "LOCATION",
"city": "OCALA",
"state": "FL",
"postal_code": "344710134",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "6061 SW 13TH ST",
"address_purpose": "LOCATION",
"city": "WEST MIAMI",
"state": "FL",
"postal_code": "331445720",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5455 SW 28TH AVE",
"address_purpose": "LOCATION",
"city": "OCALA",
"state": "FL",
"postal_code": "344719549",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3038 SW 41ST LN",
"address_purpose": "LOCATION",
"city": "OCALA",
"state": "FL",
"postal_code": "344745860",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1418 LAKE DANIEL DR",
"address_purpose": "LOCATION",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328043420",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "7302 SE 12TH CIR",
"address_purpose": "LOCATION",
"city": "OCALA",
"state": "FL",
"postal_code": "344806650",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3877 SE 5TH AVE",
"address_purpose": "LOCATION",
"city": "OCALA",
"state": "FL",
"postal_code": "344802703",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "162 LAURELWOOD LN",
"address_purpose": "LOCATION",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "321744227",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "URB MONTEHIEDRA 238 CALLE JILGUERO",
"address_purpose": "LOCATION",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009267107",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3100 SAINT JOHNS DR",
"address_purpose": "LOCATION",
"city": "DALLAS",
"state": "TX",
"postal_code": "752052938",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "87 S RIVERWALK DR",
"address_purpose": "LOCATION",
"city": "PALM COAST",
"state": "FL",
"postal_code": "321371318",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1500 SW 5TH ST",
"address_purpose": "LOCATION",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333127507",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "437 TRITON RD",
"address_purpose": "LOCATION",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "321765459",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1122 SE 46TH ST",
"address_purpose": "LOCATION",
"city": "OCALA",
"state": "FL",
"postal_code": "344804734",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "608 JOHN ANDERSON DR",
"address_purpose": "LOCATION",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "321764763",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3879 SE 6TH AVE",
"address_purpose": "LOCATION",
"city": "OCALA",
"state": "FL",
"postal_code": "344804794",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "31 HUNTER RIDGE RD",
"address_purpose": "LOCATION",
"city": "MONROE",
"state": "CT",
"postal_code": "064682447",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4420 SE 48TH PLACE RD",
"address_purpose": "LOCATION",
"city": "OCALA",
"state": "FL",
"postal_code": "344804906",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1194 SW 37TH PLACE RD",
"address_purpose": "LOCATION",
"city": "OCALA",
"state": "FL",
"postal_code": "344717232",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1111 ROSLAND CIR",
"address_purpose": "LOCATION",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309099846",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1320 KAINUI DR",
"address_purpose": "LOCATION",
"city": "KAILUA",
"state": "HI",
"postal_code": "967341935",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5 Washington St Apt 318",
"address_purpose": "LOCATION",
"city": "Brighton",
"state": "MA",
"postal_code": "021357457",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1048 SE 69TH PL",
"address_purpose": "LOCATION",
"city": "OCALA",
"state": "FL",
"postal_code": "344806642",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "25 RIVER RIDGE TRL",
"address_purpose": "LOCATION",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "321744341",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1507 OAK FOREST DR",
"address_purpose": "LOCATION",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "321743409",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4820 SW 48th Ave Unit 305",
"address_purpose": "LOCATION",
"city": "Ocala",
"state": "FL",
"postal_code": "344746303",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "15517 SHOREBIRD LN",
"address_purpose": "LOCATION",
"city": "WINTER GARDEN",
"state": "FL",
"postal_code": "347874379",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "213 SE 15TH AVE",
"address_purpose": "LOCATION",
"city": "OCALA",
"state": "FL",
"postal_code": "344712438",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1352 SE 42ND RD",
"address_purpose": "LOCATION",
"city": "OCALA",
"state": "FL",
"postal_code": "344802769",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4363 S ATLANTIC AVE",
"address_purpose": "LOCATION",
"city": "PONCE INLET",
"state": "FL",
"postal_code": "321276941",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "10 CALLE M RIVERA FERRER",
"address_purpose": "LOCATION",
"city": "GUAYNABO",
"state": "PR",
"postal_code": "009684611",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1920 W GRANADA BLVD",
"address_purpose": "LOCATION",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "321746739",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "387 LEONI ST",
"address_purpose": "LOCATION",
"city": "NEW SMYRNA BEACH",
"state": "FL",
"postal_code": "321684525",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "129 ARNAU CT",
"address_purpose": "LOCATION",
"city": "ST AUGUSTINE",
"state": "FL",
"postal_code": "320958873",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1920 W GRANADA BLVD",
"address_purpose": "LOCATION",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "321746739",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3707 BURNT PINE DR",
"address_purpose": "LOCATION",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322240855",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "185 HEATHERTON WAY",
"address_purpose": "LOCATION",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271044445",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2315 SE 24TH AVE",
"address_purpose": "LOCATION",
"city": "OCALA",
"state": "FL",
"postal_code": "344718356",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "56 FOXCROFT RUN",
"address_purpose": "LOCATION",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "321742475",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "244 HORTON GROVE RD",
"address_purpose": "LOCATION",
"city": "FORT MILL",
"state": "SC",
"postal_code": "297157845",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "878 CREEKWOOD DR",
"address_purpose": "LOCATION",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "321741445",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "511 PONCE DE LEON AVE",
"address_purpose": "LOCATION",
"city": "NORTH AUGUSTA",
"state": "SC",
"postal_code": "298414166",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4616 SE 12TH AVE",
"address_purpose": "LOCATION",
"city": "OCALA",
"state": "FL",
"postal_code": "344804755",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1181 DIXON DR",
"address_purpose": "LOCATION",
"city": "GAINESVILLE",
"state": "GA",
"postal_code": "305012920",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "90 LAKEVIEW PASS WAY",
"address_purpose": "LOCATION",
"city": "SAINT JOHNS",
"state": "FL",
"postal_code": "322595961",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "202 PHILLIPS PL",
"address_purpose": "LOCATION",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328061218",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5601 SE HIGHWAY 42",
"address_purpose": "LOCATION",
"city": "SUMMERFIELD",
"state": "FL",
"postal_code": "344915137",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "918 DOMINION HILL DR",
"address_purpose": "LOCATION",
"city": "CARY",
"state": "NC",
"postal_code": "275199347",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4507 GLEN KERNAN PKWY E",
"address_purpose": "LOCATION",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322245628",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "16 LYDA DR",
"address_purpose": "LOCATION",
"city": "MILFORD",
"state": "CT",
"postal_code": "064603755",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2805 SE 22ND AVE",
"address_purpose": "LOCATION",
"city": "OCALA",
"state": "FL",
"postal_code": "344711017",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1204 N PENINSULA AVE",
"address_purpose": "LOCATION",
"city": "NEW SMYRNA BEACH",
"state": "FL",
"postal_code": "321692226",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2 SHEFFIELD PL",
"address_purpose": "LOCATION",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271042046",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "12724 WESTWOOD LAKES BLVD",
"address_purpose": "LOCATION",
"city": "TAMPA",
"state": "FL",
"postal_code": "336262345",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "190 CLEARBLUE LOOP",
"address_purpose": "LOCATION",
"city": "SUMMERVILLE",
"state": "SC",
"postal_code": "294865405",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "7091 SW 60TH LN",
"address_purpose": "LOCATION",
"city": "OCALA",
"state": "FL",
"postal_code": "344741943",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2337 CRIMSON KING DR",
"address_purpose": "LOCATION",
"city": "BRASELTON",
"state": "GA",
"postal_code": "305174020",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "882 WHITE HORSE DR",
"address_purpose": "LOCATION",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278347833",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5335 TILDENS GROVE BLVD",
"address_purpose": "LOCATION",
"city": "WINDERMERE",
"state": "FL",
"postal_code": "347865706",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "120 Ave Chardon, Apt 1501 Sur",
"address_purpose": "LOCATION",
"city": "San Juan",
"state": "PR",
"postal_code": "009181721",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "930 WYNHAVEN LN",
"address_purpose": "LOCATION",
"city": "BALLWIN",
"state": "MO",
"postal_code": "630112938",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "7254 SE 12TH CIR",
"address_purpose": "LOCATION",
"city": "OCALA",
"state": "FL",
"postal_code": "344806650",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5637 SW 50TH TER",
"address_purpose": "LOCATION",
"city": "OCALA",
"state": "FL",
"postal_code": "344744743",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1209 SE 14TH ST",
"address_purpose": "LOCATION",
"city": "OCALA",
"state": "FL",
"postal_code": "344714523",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1615 SE 7TH ST",
"address_purpose": "LOCATION",
"city": "OCALA",
"state": "FL",
"postal_code": "344714004",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "7627 SE 12TH CIR",
"address_purpose": "LOCATION",
"city": "OCALA",
"state": "FL",
"postal_code": "344806648",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "6211 Grand Marina Cir",
"address_purpose": "LOCATION",
"city": "Gainesville",
"state": "GA",
"postal_code": "305067805",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5964 SW 73RD TER",
"address_purpose": "LOCATION",
"city": "OCALA",
"state": "FL",
"postal_code": "344742036",
"country_code": "US",
"telephone_number": "843-881-0100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "EAST COOPER PHYSICIAN GROUP LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-10-16",
"last_updated": "2026-09-18",
"certification_date": "2026-09-18",
"status": "A",
"authorized_official_last_name": "WALTON",
"authorized_official_first_name": "LEEA",
"authorized_official_middle_name": "JEANINE",
"authorized_official_title_or_position": "RCS MANAGER",
"authorized_official_telephone_number": "704-316-6081"
},
"taxonomies": [
{
"code": "2085B0100X",
"taxonomy_group": "",
"desc": "Radiology, Body Imaging",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Novant Health Diagnostic Imaging at East Cooper",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Mount Pleasant, SC
- East Cooper Physician Group LLC (Lowcountry OB/GYN)
- East Cooper Physician Group LLC (Charleston Institute for Advanced Orthopedics (CIAO))
- East Cooper Physician Group LLC (East Cooper Vascular Surgery)
- East Cooper Physician Group LLC (High Tide Internal Medicine - East Cooper Medical Group)
- East Cooper Physician Group LLC (Novant Health Mullis Internal Medicine)
- East Cooper Physician Group LLC
- East Cooper Physician Group LLC (Revela Assisted Living)
- East Cooper Physician Group LLC (East Cooper Medical Center)
- East Cooper Physician Group LLC (Lowcountry Gastroenterology Associates of Charleston)
- East Cooper Physician Group LLC (East Cooper Center for Pelvic Medicine)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2026; 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.