NPIMap

Organization Active NPI

PPCP Specialty Physicians, LLC

  • Gastroenterology Physician
  • Moncks Corner, SC
National Provider Identifier
1861931982
Registry record updated Jun 8, 2021
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
730 Stony Landing Rd
Ste 200
Moncks Corner, SC 29461-2904
Phone
(843) 376-0670
Fax
(843) 376-0669
NPI assigned
Feb 22, 2017
Last updated
Jun 8, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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

Authorized official

Name
Dr. Thomas Brantley Arnau, MDNPI 1477510022
Title
President
Phone
(843) 572-7727

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

730 Stony Landing Rd
Ste 200
Moncks Corner, SC 29461-2904

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
This NPI is an additional NPI on the 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
Tax ID family
PPCP Specialty Physicians10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

5500 Front St
Ste 260
Summerville, SC 29486
Phone (843) 576-0700

Practitioners & affiliated clinicians

Practitioners 6

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": "1487721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623110400000",
    "number": "1861931982",
    "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": "730 STONY LANDING RD",
            "address_2": "STE 200",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294612904",
            "telephone_number": "843-376-0670",
            "fax_number": "843-376-0669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PPCP SPECIALTY PHYSICIANS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-22",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A",
        "authorized_official_last_name": "ARNAU",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "BRANTLEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-572-7727",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "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 Moncks Corner, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; 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.