Organization Active NPI

Cancer Control Center of Charleston,LLC

  • Hematology & Oncology Physician
  • Mt Pleasant, SC
National Provider Identifier
1912178682
Registry record updated Mar 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
17188 Issued in SC
Legal business name
CANCER CONTROL CENTER OF CHARLESTON,LLC
Practice address
1405 Ben Sawyer Blvd
Mt Pleasant, SC 29464-5519
Phone
(843) 884-8121
NPI assigned
Mar 20, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2008

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

Authorized official

Name
Daniel Nixon, MDNPI 1306880331
Title
Physician
Phone
(843) 884-8121

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0003X 17188 SC Primary

Addresses

Primary practice location

1405 Ben Sawyer Blvd
Mt Pleasant, SC 29464-5519

Mailing address

PO Box 100523
Florence, SC 29501-0523
Phone (843) 669-5162

Other identifiers 1

IdentifierTypeStateIssuer
GP4232MedicaidSC

National Provider Directory

National Provider Directory

Locations

2097 Henry Tecklenburg Dr
Ste 203W
Charleston, SC 29414
Phone (843) 573-3444

1405 Ben Sawyer Blvd
Ste 105
Mt Pleasant, SC 29464
Phone (843) 884-8121

1405 Ben Sawyer Blvd
Mt Pleasant, SC 29464
Phone (843) 884-8121

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": "1205971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205971200000",
    "number": "1912178682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100523",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295010523",
            "telephone_number": "843-669-5162",
            "fax_number": "843-667-4573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 BEN SAWYER BLVD",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294645519",
            "telephone_number": "843-884-8121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANCER CONTROL CENTER OF CHARLESTON,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-20",
        "last_updated": "2008-03-20",
        "status": "A",
        "authorized_official_last_name": "NIXON",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "843-884-8121",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "SC",
            "license": "17188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4232",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.