NPIMap

Organization Active NPI

The Cypress Club, Inc.

Doing business as The Cypress Club Clinic

  • Health Service Clinic/Center
  • Hilton Head Island, SC
National Provider Identifier
1710109822
Registry record updated Jul 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
THE CYPRESS CLUB, INC.
Doing business as
The Cypress Club Clinic
Practice address
20 Ladyslipper LN
Hilton Head Island, SC 29926
Phone
(843) 682-7116
Fax
(843) 689-7084
NPI assigned
May 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2018

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

Authorized official

Name
Mr. Marc Anthony Puntereri
Title
Executive Vice President
Phone
(843) 689-7007

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

20 Ladyslipper LN
Hilton Head Island, SC 29926

Mailing address

20 Ladyslipper LN
Hilton Head Island, SC 29926-1372
Phone (843) 682-7116

Other names 1

  • THE CYPRESS CLUB CLINIC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040310001016 SC Part B Supplier - Clinic/Group Practice 7810885779 Receives reassigned benefits from 2 practitioners
Practice locations: Hilton Head Island, SC

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
The Cypress Club Clinic3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Preston Health CenterHilton Head, SC, CCN 425325 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 2, 1992

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532995200000",
    "number": "1710109822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 LADYSLIPPER LN",
            "city": "HILTON HEAD ISLAND",
            "state": "SC",
            "postal_code": "299261372",
            "telephone_number": "843-682-7116",
            "fax_number": "843-689-7084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 LADYSLIPPER LN",
            "city": "HILTON HEAD ISLAND",
            "state": "SC",
            "postal_code": "29926",
            "telephone_number": "843-682-7116",
            "fax_number": "843-689-7084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CYPRESS CLUB, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2018-07-31",
        "status": "A",
        "authorized_official_last_name": "PUNTERERI",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "843-689-7007",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE CYPRESS CLUB CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "THE CYPRESS CLUB CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hilton Head Island, SC

Sources for this page

Verify at the official NPI Registry.