| Ppcp Specialty Physicians , Llc | |
|
7 S Alliance Dr Ste 202-a Goose Creek SC 29445-7269 | |
| (843) 376-6070 | |
| (843) 376-0669 |
| Full Name | Ppcp Specialty Physicians , Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 7 S Alliance Dr, Goose Creek, South Carolina |
| Authorized Official Name and Position | Terry Cunningham (CEO) |
| Authorized Official Contact | 8435727727 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ppcp Specialty Physicians , Llc Po Box 530062 Atlanta GA 30353-0062 Ph: (843) 695-6071 | Ppcp Specialty Physicians , Llc 7 S Alliance Dr Ste 202-a Goose Creek SC 29445-7269 Ph: (843) 376-6070 |
| NPI Number | 1780123984 |
|---|---|
| Provider Enumeration Date | 02/21/2017 |
| Last Update Date | 02/28/2022 |
| Medicare PECOS PAC ID | 2466723028 |
|---|---|
| Medicare Enrollment ID | O20170801001865 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780123984 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 29748 (South Carolina) | Primary |
| Provider Name | John H Lucas |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1679571020 PECOS PAC ID: 1153396932 Enrollment ID: I20040826000920 |
| Provider Name | Aaron Domm |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1760527576 PECOS PAC ID: 8224016829 Enrollment ID: I20070723000907 |
| Provider Name | Marc New |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1831170612 PECOS PAC ID: 1052329224 Enrollment ID: I20100923000744 |
| Provider Name | Joseph Mathews |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811123300 PECOS PAC ID: 8325297534 Enrollment ID: I20121003000800 |
| Provider Name | Colleen H Boyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740524768 PECOS PAC ID: 2264676220 Enrollment ID: I20130913000516 |
| Provider Name | Robert M Carlile |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1740575307 PECOS PAC ID: 3476847716 Enrollment ID: I20160809001006 |
| Provider Name | Amelia Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205316858 PECOS PAC ID: 8325383623 Enrollment ID: I20181214000097 |
| Provider Name | Amanda E Hare |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245748029 PECOS PAC ID: 9638410574 Enrollment ID: I20190403000571 |
| Provider Name | Lisa Burgess |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073132502 PECOS PAC ID: 7416371695 Enrollment ID: I20200721002305 |
| Provider Name | Brett Daniel Van Leer Greenberg |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1871911867 PECOS PAC ID: 5294150942 Enrollment ID: I20200729001157 |
| Provider Name | Dawn Marie Wolak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093815235 PECOS PAC ID: 3274530274 Enrollment ID: I20211229000177 |
| Provider Name | Katalina R Funke |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1386024099 PECOS PAC ID: 8325348865 Enrollment ID: I20220325001902 |
| Provider Name | Allison S Riley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427729664 PECOS PAC ID: 5294112306 Enrollment ID: I20220511000755 |
| Provider Name | Kennedy Goode Holcombe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477134880 PECOS PAC ID: 3971980525 Enrollment ID: I20220519002208 |
| Provider Name | James Thorolf Peveler |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1265784409 PECOS PAC ID: 8123320066 Enrollment ID: I20230322000730 |
| Provider Name | Emily Kachelmeyer |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1396466991 PECOS PAC ID: 3870969751 Enrollment ID: I20230413002236 |
| Provider Name | Chuma Obineme |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1386175552 PECOS PAC ID: 1850664038 Enrollment ID: I20230725000240 |
Liberty Doctors Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 110a Springhall Dr, Goose Creek, SC 29445 Phone: 843-225-8304 Fax: 843-225-3549 | |
Primecare Family Practice Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 145 St James Ave, Goose Creek, SC 29445 Phone: 843-863-0777 Fax: 843-824-6119 | |
Roper Saint Francis Physicians Network Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 120 Spring Hall Dr, Suite B, Goose Creek, SC 29445 Phone: 843-266-3430 Fax: 843-266-1997 | |
Palmetto Primary Care Physicians, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7 S Alliance Dr, Ste 202-a, Goose Creek, SC 29445 Phone: 843-553-4383 Fax: 843-553-4384 | |
Liberty Doctors Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 110a Springhall Dr, Goose Creek, SC 29445 Phone: 843-973-8503 Fax: 843-990-5068 | |
Lowcountry Medical Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 120 Springhall Dr, Suite B, Goose Creek, SC 29445 Phone: 843-266-3430 | |
Palmetto Primary Care Physicians, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7 South Alliance Drive, Ste 201a, Goose Creek, SC 29445 Phone: 843-553-4383 Fax: 843-553-4384 |