NPIMap

Organization Active NPI

PPCP Specialty Physicians , LLC

  • Gastroenterology Physician
  • Goose Creek, SC
National Provider Identifier
1780123984
Registry record updated Feb 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
29748 Issued in SC
Legal business name
PPCP SPECIALTY PHYSICIANS , LLC
Practice address
7 S Alliance Dr
Ste 202-a
Goose Creek, SC 29445-7269
Phone
(843) 376-6070
Fax
(843) 376-0669
NPI assigned
Feb 21, 2017
Last updated
Feb 28, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2022

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

Authorized official

Name
Terry Cunningham
Title
Ceo
Phone
(843) 572-7727

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X 29748 SC Primary

Addresses

Primary practice location

7 S Alliance Dr
Ste 202-a
Goose Creek, SC 29445-7269

Mailing address

PO Box 530062
Atlanta, GA 30353-0062
Phone (843) 695-6071

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170801001865 SC Part B Supplier - Clinic/Group Practice 2466723028 Receives reassigned benefits from 32 practitioners
13 other NPIs on this enrollment
Practice locations: Charleston, SC; Summerville, SC; Mt Pleasant, SC; Moncks Corner, SC; Ladson, SC; Irmo, SC; Goose Creek, SC; Daniel Island, SC…

Other NPIs on the same Medicare enrollment 13

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

View all 13

National Provider Directory

National Provider Directory

Locations

7 S Alliance Dr
Ste B
Goose Creek, SC 29445

1101 Old Trolley Rd
Ste 300
Summerville, SC 29485
Phone (843) 376-2670

130 Edge St
Summerville, SC 29486
Phone (843) 628-5816

550 FRNT St Ste 260
Summerville, SC 29486

Practitioners & affiliated clinicians

Practitioners 32

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 32

NPI Registry JSON

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

{
    "created_epoch": "1487635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646006400000",
    "number": "1780123984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 530062",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303530062",
            "telephone_number": "843-695-6071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 S ALLIANCE DR",
            "address_2": "STE 202-A",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294457269",
            "telephone_number": "843-376-6070",
            "fax_number": "843-376-0669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PPCP SPECIALTY PHYSICIANS , LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-21",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A",
        "authorized_official_last_name": "CUNNINGHAM",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "843-572-7727"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "SC",
            "license": "29748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goose Creek, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2022; 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.