NPIMap

Organization Active NPI

East Cooper Physician Group LLC

Doing business as Revela Assisted Living

  • Internal Medicine Physician
  • Daniel Island, SC
National Provider Identifier
1942071667
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
EAST COOPER PHYSICIAN GROUP LLC
Doing business as
Revela Assisted Living
Practice address
880 Island Park Dr Unit 230
Daniel Island, SC 29492-2902
Phone
(843) 380-9330
NPI assigned
Jan 11, 2024
Last updated
Sep 2, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Authorized official

Name
Doreatha Rogers
Title
RCS Manager
Phone
(980) 302-7992

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

880 Island Park Dr Unit 230
Daniel Island, SC 29492-2902

Mailing address

PO Box 37642
Belfast, ME 04915-1218

Other names 1

  • Revela Assisted Living Doing business as

National Provider Directory

National Provider Directory
Tax ID family
East Cooper Physician Group LLC49 organizations share this tax ID, including this one

Other organizations with this tax ID 48

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

View all 48

Locations

2199 N Fraser St
Georgetown, SC 29440
Phone (843) 527-0225

1625 Hospital Dr
Ste 360
Mt Pleasant, SC 29464
Phone (843) 936-5951

NPI Registry JSON

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

{
    "created_epoch": "1704931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1942071667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37642",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049151218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 ISLAND PARK DR UNIT 230",
            "city": "DANIEL ISLAND",
            "state": "SC",
            "postal_code": "294922902",
            "telephone_number": "843-380-9330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST COOPER PHYSICIAN GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-11",
        "last_updated": "2025-09-02",
        "certification_date": "2024-02-01",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "DOREATHA",
        "authorized_official_title_or_position": "RCS MANAGER",
        "authorized_official_telephone_number": "980-302-7992"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Revela Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Daniel Island, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; 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.