NPIMap

Organization Active NPI

East Cooper Physician Group LLC

  • Family Medicine Physician
  • Daniel Island, SC
National Provider Identifier
1972374601
Registry record updated Feb 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
EAST COOPER PHYSICIAN GROUP LLC
Practice address
880 Island Park Dr Unit 200
Daniel Island, SC 29492-2902
Phone
(843) 856-1771
Fax
(843) 856-8788
NPI assigned
Jan 11, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2026

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
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

880 Island Park Dr Unit 200
Daniel Island, SC 29492-2902

Mailing address

PO Box 604408
Charlotte, NC 28260-4408

Other names 1

  • Novant Health Island Park Family Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240214000176 SC Part B Supplier - Clinic/Group Practice 1254775687 Receives reassigned benefits from 173 practitioners
31 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Goose Creek, SC; Summerville, SC; North Augusta, SC; Mt Pleasant, SC; Mount Pleasant, SC; Beaufort, SC; Georgetown, SC; Fort Mill, SC…

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

Other NPIs on the same Medicare enrollment 31

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

View all 31

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D2018993Novant Health Island Park Family Medicine880 Island Park Drive, Daniel Island, SC 29492Certificate of waiverJan 19, 2027

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": "1772236800000",
    "number": "1972374601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 604408",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282604408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 ISLAND PARK DR UNIT 200",
            "city": "DANIEL ISLAND",
            "state": "SC",
            "postal_code": "294922902",
            "telephone_number": "843-856-1771",
            "fax_number": "843-856-8788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST COOPER PHYSICIAN GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-11",
        "last_updated": "2026-02-28",
        "certification_date": "2026-02-28",
        "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": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Island Park Family Medicine",
            "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 Feb 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.