Individual provider Active NPI

Gary John Cianci, M.D.

  • Family Medicine Physician
  • Charleston, SC
National Provider Identifier
1710062575
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
37635 Issued in SC
Practice address
319 Folly Rd
Charleston, SC 29412-2518
Phone
(843) 203-2246
Fax
(843) 203-2247
NPI assigned
Oct 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 37635 SC Primary

Addresses

Primary practice location

319 Folly Rd
Charleston, SC 29412-2518

Mailing address

PO Box 751649
Charlotte, NC 28275-1649
Phone (843) 789-1620

Other identifiers 1

IdentifierTypeStateIssuer
376355MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170425000244 SC Practitioner - Family Practice 0345322475 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Roper Saint Francis Physicians Network Current Accepting new patients
Roper Saint Francis Physicians Network Family Medicine CurrentSince Apr 17, 2017 Accepting new patients
Roper Saint Francis Physicians Network CurrentSince Apr 17, 2017 Accepting new patients
Dupage Medical Group LTD Past Accepting new patients
Dupage Medical Group LTD PastSince Jul 1, 2008 Accepting new patients

Locations

319 Folly Rd
Charleston, SC 29412
Phone (843) 203-2246

8536 Palmetto Commerce Pkwy
Ste 401
Ladson, SC 29456
Phone (843) 203-2260

2075 Eagle Landing Blvd
North Charleston, SC 29406
Phone (843) 797-5747

5070 International Blvd
Ste 131
North Charleston, SC 29418
Phone (843) 402-2995

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1710062575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751649",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751649",
            "telephone_number": "843-789-1620",
            "fax_number": "843-724-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 FOLLY RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294122518",
            "telephone_number": "843-203-2246",
            "fax_number": "843-203-2247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIANCI",
        "first_name": "GARY",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "37635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376355",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.