NPIMap

Organization Active NPI

Roper Saint Francis Physicians Network

Doing business as Harborside OB-GYN

  • Obstetrics & Gynecology Physician
  • Mount Pleasant, SC
National Provider Identifier
1902047236
Registry record updated Jul 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
ROPER SAINT FRANCIS PHYSICIANS NETWORK
Doing business as
Harborside OB-GYN
Practice address
570 Long Point Rd
Suite 130
Mt Pleasant, SC 29464-7930
Phone
(843) 789-1800
Fax
(843) 724-1306
NPI assigned
Mar 17, 2009
Last updated
Jul 8, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2010

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

Authorized official

Name
Mr. Douglas Bowling
Title
Ceo Roper Saint Francis Physicians
Phone
(843) 724-2903

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

570 Long Point Rd
Suite 130
Mt Pleasant, SC 29464-7930

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
DP0704OtherSCRAILROAD MEDICARE GROUP PTAN
GP5127MedicaidSC

Other names 1

  • Harborside OB-GYN Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090528000405 SC Part B Supplier - Clinic/Group Practice 5193874824 Receives reassigned benefits from 837 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Roper Hospital Inc235 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 1

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": "1237248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278547200000",
    "number": "1902047236",
    "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": "570 LONG POINT RD",
            "address_2": "SUITE 130",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294647930",
            "telephone_number": "843-789-1800",
            "fax_number": "843-724-1306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROPER SAINT FRANCIS PHYSICIANS NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-17",
        "last_updated": "2010-07-08",
        "status": "A",
        "authorized_official_last_name": "BOWLING",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "CEO ROPER SAINT FRANCIS PHYSICIANS",
        "authorized_official_telephone_number": "843-724-2903",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP PTAN",
            "identifier": "DP0704",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP5127",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harborside OB-GYN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2010; 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.