| Roper Hospital, Inc. | |
|
1481 Tobias Gadson Blvd Suite 1 Charleston SC 29407-4794 | |
| (843) 402-3093 | |
| (843) 402-3094 |
| Full Name | Roper Hospital, Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 1481 Tobias Gadson Blvd, Charleston, South Carolina |
| Authorized Official Name and Position | Rebecca Tucker (CFO) |
| Authorized Official Contact | 8437273403 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Roper Hospital, Inc. Po Box 751649 Charlotte NC 28275-1649 Ph: (888) 472-0043 | Roper Hospital, Inc. 1481 Tobias Gadson Blvd Suite 1 Charleston SC 29407-4794 Ph: (843) 402-3093 |
| NPI Number | 1104150739 |
|---|---|
| Provider Enumeration Date | 09/30/2009 |
| Last Update Date | 06/05/2025 |
| Medicare PECOS PAC ID | 8426958919 |
|---|---|
| Medicare Enrollment ID | O20041228000500 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104150739 | NPI | - | NPPES |
| 088/093 | Other | SC | TRICARE SUFFIX |
| 083 | Other | SC | BCBS SC AND BLUECHOICE SUFIX |
| GP5274 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (South Carolina) | Secondary |
| 207RI0200X | Internal Medicine - Infectious Disease | (South Carolina) | Primary |
| Provider Name | John M Ernst |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1619902905 PECOS PAC ID: 0244126720 Enrollment ID: I20040223000700 |
| Provider Name | James J Carswell |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1720038805 PECOS PAC ID: 1557353893 Enrollment ID: I20040330000809 |
| Provider Name | Bryan Henry Frain |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1053377507 PECOS PAC ID: 3870570575 Enrollment ID: I20040701000101 |
| Provider Name | Brett Matthew Baker |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1861458853 PECOS PAC ID: 9739166588 Enrollment ID: I20040701000119 |
| Provider Name | David Keith Handshoe |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1659371755 PECOS PAC ID: 1052386794 Enrollment ID: I20040827000067 |
| Provider Name | John Michael Rucker |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1568462661 PECOS PAC ID: 9234104985 Enrollment ID: I20040827000077 |
| Provider Name | Thomas D Kaelin |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1740280841 PECOS PAC ID: 5698749695 Enrollment ID: I20040827000085 |
| Provider Name | Sarbabi Masindet |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1457464471 PECOS PAC ID: 2668431636 Enrollment ID: I20041006000007 |
| Provider Name | Sola Kim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508864968 PECOS PAC ID: 7214996222 Enrollment ID: I20041006000296 |
| Provider Name | Lance Lee Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003864521 PECOS PAC ID: 1557327905 Enrollment ID: I20041207000783 |
| Provider Name | Jeffrey S Rieder |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1255397519 PECOS PAC ID: 7315915105 Enrollment ID: I20050310000742 |
| Provider Name | Donald E Saunders |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1861485088 PECOS PAC ID: 2163476268 Enrollment ID: I20050311000098 |
| Provider Name | Scott Latimer Woodfield |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1568455723 PECOS PAC ID: 6901850007 Enrollment ID: I20050311000158 |
| Provider Name | Kenneth H Hanger |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1992798235 PECOS PAC ID: 1850350778 Enrollment ID: I20050311000215 |
| Provider Name | William B Ellison |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1356307318 PECOS PAC ID: 1557315579 Enrollment ID: I20050311000299 |
| Provider Name | Lars Hokan Runquist |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1821054537 PECOS PAC ID: 7416901434 Enrollment ID: I20050311000328 |
| Provider Name | Robert A Pringle |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1124011424 PECOS PAC ID: 6800840836 Enrollment ID: I20050311000394 |
| Provider Name | Gregory B Miller |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1770688764 PECOS PAC ID: 8325095334 Enrollment ID: I20050401000491 |
| Provider Name | William J Grossman |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1023068897 PECOS PAC ID: 5597754101 Enrollment ID: I20050405001213 |
| Provider Name | Barbara P Hildreth |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043275357 PECOS PAC ID: 4183668361 Enrollment ID: I20050617000885 |
| Provider Name | Theresa W Dryden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164408233 PECOS PAC ID: 2961491766 Enrollment ID: I20070208000152 |
| Provider Name | Graham C Scott |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1265481303 PECOS PAC ID: 2860596608 Enrollment ID: I20070426000040 |
| Provider Name | Hamid R Bahadori |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1861571887 PECOS PAC ID: 4587765219 Enrollment ID: I20070725000596 |
| Provider Name | Matthew B O'steen |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1346285087 PECOS PAC ID: 0446263644 Enrollment ID: I20070808000257 |
| Provider Name | Troy A Bunting |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1558588962 PECOS PAC ID: 5597859215 Enrollment ID: I20070925000551 |
| Provider Name | Michael Alan Spandorfer |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1134122112 PECOS PAC ID: 9638136286 Enrollment ID: I20071003000202 |
| Provider Name | Toby Lynn Fugate |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1295870186 PECOS PAC ID: 6709853948 Enrollment ID: I20071108000548 |
| Provider Name | Nancey Trevanian Tsai |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1205938040 PECOS PAC ID: 3779581244 Enrollment ID: I20071227000600 |
| Provider Name | Scott D Ross |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1164413563 PECOS PAC ID: 9830124411 Enrollment ID: I20080102000014 |
| Provider Name | Byron N Bailey |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1508804857 PECOS PAC ID: 6204917040 Enrollment ID: I20080117000429 |
| Provider Name | Robert G Quattlebaum |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083704175 PECOS PAC ID: 3577639095 Enrollment ID: I20080908000343 |
| Provider Name | Roy W King |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1861447443 PECOS PAC ID: 1850390147 Enrollment ID: I20081119000755 |
| Provider Name | Jason E Gunn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386760080 PECOS PAC ID: 7810045770 Enrollment ID: I20090501000447 |
| Provider Name | James S Hawk |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629293212 PECOS PAC ID: 8729131347 Enrollment ID: I20090729000885 |
| Provider Name | Jennifer L Lewey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275860066 PECOS PAC ID: 1254468762 Enrollment ID: I20100414000697 |
| Provider Name | John Albert Mitchell |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1205886124 PECOS PAC ID: 6204993496 Enrollment ID: I20100615000461 |
| Provider Name | Cynthia Heldrich |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1841247707 PECOS PAC ID: 4688705882 Enrollment ID: I20100702000371 |
| Provider Name | William T Dawson |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1548210982 PECOS PAC ID: 2769549955 Enrollment ID: I20100924000435 |
| Provider Name | Thomas Corbett Appleby |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1801985007 PECOS PAC ID: 3971569468 Enrollment ID: I20100924000515 |
| Provider Name | Steve E Herndon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861516668 PECOS PAC ID: 4688790421 Enrollment ID: I20100929000619 |
| Provider Name | Jason Huet |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1841415155 PECOS PAC ID: 5294920062 Enrollment ID: I20101108000309 |
| Provider Name | James L Bumgartner |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1477522845 PECOS PAC ID: 7416131032 Enrollment ID: I20110406000390 |
| Provider Name | Charles Jervey |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1801865365 PECOS PAC ID: 5799751921 Enrollment ID: I20110510000676 |
| Provider Name | James T Reed |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1578609699 PECOS PAC ID: 3678641958 Enrollment ID: I20120208000023 |
| Provider Name | Lauren Dubose Neese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427320068 PECOS PAC ID: 6002075538 Enrollment ID: I20120301000935 |
| Provider Name | Jessica Michelle Chepa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629327713 PECOS PAC ID: 4587814140 Enrollment ID: I20121017000628 |
| Provider Name | Corynne A Boyer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912138983 PECOS PAC ID: 1153477070 Enrollment ID: I20121101000445 |
| Provider Name | Mary K Logan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235576810 PECOS PAC ID: 9436392628 Enrollment ID: I20130909000433 |
| Provider Name | Deborah E Still |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568788867 PECOS PAC ID: 2163666934 Enrollment ID: I20130917000413 |
| Provider Name | Todd J Metz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588092662 PECOS PAC ID: 0244461606 Enrollment ID: I20140327001598 |
| Provider Name | Pamela L Eliason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346453065 PECOS PAC ID: 4688806565 Enrollment ID: I20140408000305 |
| Provider Name | Katherine A Minnick |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1649276502 PECOS PAC ID: 3375775844 Enrollment ID: I20140415002131 |
| Provider Name | Sandra S Munaco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225448723 PECOS PAC ID: 0840414983 Enrollment ID: I20140612000102 |
| Provider Name | Vishal Abiraj |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356652283 PECOS PAC ID: 8820239783 Enrollment ID: I20140814000873 |
| Provider Name | Leslie Dawn Wilke |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548460744 PECOS PAC ID: 4688860547 Enrollment ID: I20140827002989 |
| Provider Name | Stephanie A James |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982043717 PECOS PAC ID: 9234350497 Enrollment ID: I20141031002244 |
| Provider Name | James Willis Fitzpatrick |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760475859 PECOS PAC ID: 3577522663 Enrollment ID: I20141208001640 |
| Provider Name | Kayla C Hanks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861895393 PECOS PAC ID: 2466776331 Enrollment ID: I20150123001967 |
| Provider Name | Monique Kaur Sandhu |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1306043823 PECOS PAC ID: 6709103385 Enrollment ID: I20150318002467 |
| Provider Name | Anisha S Hezekiah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689094997 PECOS PAC ID: 0547588600 Enrollment ID: I20150421002347 |
| Provider Name | Minh K Tran |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1346477494 PECOS PAC ID: 7618280603 Enrollment ID: I20150720003104 |
| Provider Name | David J Powell |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1043539406 PECOS PAC ID: 5294975496 Enrollment ID: I20150906000000 |
| Provider Name | Sandra S Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023484946 PECOS PAC ID: 6901109214 Enrollment ID: I20160120002100 |
| Provider Name | Nicholas Batchelor |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1831266956 PECOS PAC ID: 5597996942 Enrollment ID: I20160518001262 |
| Provider Name | William Dana Largen |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1336435205 PECOS PAC ID: 0840411740 Enrollment ID: I20160602000980 |
| Provider Name | William S Ashwander |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1649414970 PECOS PAC ID: 3870739527 Enrollment ID: I20160714001805 |
| Provider Name | Kailin Marie Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528428570 PECOS PAC ID: 7315231685 Enrollment ID: I20160809002052 |
| Provider Name | Shari D Hulbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235114455 PECOS PAC ID: 7517251697 Enrollment ID: I20160812000265 |
| Provider Name | Ruth W Montemagno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821458837 PECOS PAC ID: 8224327168 Enrollment ID: I20160906000644 |
| Provider Name | Jared M Intaphan |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1639486160 PECOS PAC ID: 7315233608 Enrollment ID: I20160913001705 |
| Provider Name | Romina Ilic |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1619143898 PECOS PAC ID: 6305096967 Enrollment ID: I20170612000047 |
| Provider Name | Cynthia Diana Schumpert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750713657 PECOS PAC ID: 4284868894 Enrollment ID: I20170710000572 |
| Provider Name | Muhammad A Rashad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083843304 PECOS PAC ID: 5991010217 Enrollment ID: I20170822000234 |
| Provider Name | Moshe Mark Douglas Wexler |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1801858865 PECOS PAC ID: 2062794373 Enrollment ID: I20180320000000 |
| Provider Name | Mary Elizabeth Hanley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285678433 PECOS PAC ID: 4284710542 Enrollment ID: I20180613002140 |
| Provider Name | Selena O. Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346737673 PECOS PAC ID: 8426303843 Enrollment ID: I20180626000831 |
| Provider Name | Eunice Luz Guzman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043508708 PECOS PAC ID: 0244540979 Enrollment ID: I20180629002108 |
| Provider Name | Patrick Michael Looser |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1508165291 PECOS PAC ID: 2163779190 Enrollment ID: I20180723002445 |
| Provider Name | Michael E Field |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1033192802 PECOS PAC ID: 7113818170 Enrollment ID: I20180911000661 |
| Provider Name | Emerald Rose Banas Branch |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1548540578 PECOS PAC ID: 4082917927 Enrollment ID: I20181101002667 |
| Provider Name | Jacquelyn Suzette Ammons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669965810 PECOS PAC ID: 5698029098 Enrollment ID: I20181126000032 |
| Provider Name | Joshua A Hall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497135503 PECOS PAC ID: 1658657085 Enrollment ID: I20190221000735 |
| Provider Name | Erin R Mcbride |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841754595 PECOS PAC ID: 7719226992 Enrollment ID: I20190306000477 |
| Provider Name | Craig Anthony Schuring |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1447698360 PECOS PAC ID: 4981847464 Enrollment ID: I20190612002339 |
| Provider Name | Craig Anthony Schuring |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1447698360 PECOS PAC ID: 4981847464 Enrollment ID: I20190612003780 |
| Provider Name | Geetha F Pinto |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1831350073 PECOS PAC ID: 3870779440 Enrollment ID: I20190702003181 |
| Provider Name | Kathryn Marie Aimar Burn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720625783 PECOS PAC ID: 6709211964 Enrollment ID: I20200115002651 |
| Provider Name | Chelsey A D Massey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932747748 PECOS PAC ID: 5597190595 Enrollment ID: I20200122000871 |
| Provider Name | Janice Marie Bruce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306487343 PECOS PAC ID: 2466888789 Enrollment ID: I20200205001801 |
| Provider Name | Morgan L Rubenstein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487297420 PECOS PAC ID: 1052749769 Enrollment ID: I20200311002213 |
| Provider Name | Caitlin Marie Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417593526 PECOS PAC ID: 3870921265 Enrollment ID: I20200318001384 |
| Provider Name | Jason L Foster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356973820 PECOS PAC ID: 3476982026 Enrollment ID: I20200401003167 |
| Provider Name | Kenneth Michael Desart |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1154556603 PECOS PAC ID: 9032352752 Enrollment ID: I20200515002279 |
| Provider Name | Layne Alan Madden |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1346635612 PECOS PAC ID: 3173826070 Enrollment ID: I20200727002814 |
| Provider Name | Auryelle Ascue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558971390 PECOS PAC ID: 6507286564 Enrollment ID: I20201014000531 |
| Provider Name | Kimberly Michelle Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336741560 PECOS PAC ID: 9931510740 Enrollment ID: I20201201000182 |
| Provider Name | Shawna Lea Fox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720405277 PECOS PAC ID: 7214348846 Enrollment ID: I20201202002569 |
| Provider Name | Sierra K Burgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902495005 PECOS PAC ID: 7113331554 Enrollment ID: I20210127000532 |
| Provider Name | Jayne M Donovan |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1407172794 PECOS PAC ID: 6305003740 Enrollment ID: I20210324002494 |
| Provider Name | Michael D Moxley |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1437147758 PECOS PAC ID: 9931116662 Enrollment ID: I20210604002048 |
| Provider Name | Jonathan Paul Rehfuss |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1023370863 PECOS PAC ID: 8729217575 Enrollment ID: I20210720000809 |
| Provider Name | Blase Anthony Carabello |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1720092562 PECOS PAC ID: 9537336441 Enrollment ID: I20211207000360 |
| Provider Name | Heather Nicole Fabel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275298945 PECOS PAC ID: 9830580158 Enrollment ID: I20211221002395 |
| Provider Name | Emily Jeanne Culpepper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548854466 PECOS PAC ID: 2860884285 Enrollment ID: I20220115000192 |
| Provider Name | Caroline Ravenel Strange |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609536002 PECOS PAC ID: 8426441270 Enrollment ID: I20220131002084 |
| Provider Name | Jennifer M Reitman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215335237 PECOS PAC ID: 7810281995 Enrollment ID: I20220330002735 |
| Provider Name | Alison Marie Bondell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013551332 PECOS PAC ID: 1850787482 Enrollment ID: I20220408000111 |
| Provider Name | William Foster Gaillard |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1619315918 PECOS PAC ID: 1850535899 Enrollment ID: I20220428002845 |
| Provider Name | Stacey Lynn Childress |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083018030 PECOS PAC ID: 3476876616 Enrollment ID: I20220714003379 |
| Provider Name | Hannah Mulliken Whitesides |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376280198 PECOS PAC ID: 7810372141 Enrollment ID: I20220922000431 |
| Provider Name | Deborah Lynn Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013688969 PECOS PAC ID: 0749655678 Enrollment ID: I20230406002799 |
| Provider Name | Stephen L Schwade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790403657 PECOS PAC ID: 6709245699 Enrollment ID: I20230711000795 |
| Provider Name | Donald Frederick Bruner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114641289 PECOS PAC ID: 1052773819 Enrollment ID: I20230811000327 |
| Provider Name | Stephen Harden |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1043623135 PECOS PAC ID: 3274883780 Enrollment ID: I20230817003852 |
| Provider Name | Robert Wallace Williams Biederman |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1912907734 PECOS PAC ID: 4284728189 Enrollment ID: I20240227003147 |
| Provider Name | Grace A Cross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740994151 PECOS PAC ID: 8123465101 Enrollment ID: I20240326002908 |
| Provider Name | Joy Johnstone Geter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942884440 PECOS PAC ID: 2860833480 Enrollment ID: I20240514003197 |
| Provider Name | Leigh Ann Garbett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588416580 PECOS PAC ID: 3173965308 Enrollment ID: I20240520003020 |
| Provider Name | Whitney N Pasquini |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497377444 PECOS PAC ID: 9234674193 Enrollment ID: I20240716000495 |
| Provider Name | Adero Zari Faye Francis |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1184187205 PECOS PAC ID: 1951637560 Enrollment ID: I20240813000444 |
| Provider Name | Stephanie Nicole Driggers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225626708 PECOS PAC ID: 0840722682 Enrollment ID: I20241017001424 |
Palmetto Primary Care Physicians, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2097 Henry Tecklenburg Dr, Charleston, SC 29414 Phone: 843-572-7727 Fax: 843-569-5881 | |
Carolina Family Care, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2067 Charlie Hall Blvd, Charleston, SC 29414 Phone: 843-573-2535 | |
Roper Saint Francis Physicians Network Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 316 Calhoun St, Charleston, SC 29401 Phone: 843-724-2450 Fax: 843-724-2455 | |
Liberty Doctors Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2270 Ashley Crossing Dr Ste 155, Charleston, SC 29414 Phone: 843-990-5866 Fax: 843-868-8041 | |
East Cooper Physician Group Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10b Farmfield Ave, Charleston, SC 29407 Phone: 854-287-3135 Fax: 854-287-3136 | |
Harold R Nicolette, Do, Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6 Carriage Ln, Suite B, Charleston, SC 29407 Phone: 843-766-4100 Fax: 843-571-4177 | |
Empowerme Medical Group, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2333 Ashley River Rd, Charleston, SC 29414 Phone: 877-367-9772 |