EAST COOPER PHYSICIAN GROUP LLC – NPI #1114893096
Radiology

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

Health Care Provider Taxonomy Code for Radiology

EAST COOPER PHYSICIAN GROUP LLC is a radiologist located in MOUNT PLEASANT, SC. NPPES has assigned the NPI number 1114893096 to EAST COOPER PHYSICIAN GROUP LLC on October 16, 2025. It is a Type-2 NPI, indicating this NPI number is associated with an organization. According to the NPI Registry, there are 3 additional location(s) assigned to this provider which are listed below. The primary taxonomy selected by this provider is 2085R0202X from the Health Care Provider Taxonomy code set, which is classified as Radiology, specializing in Diagnostic Radiology

The NPI profile was last updated on Jan 22, 2026. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for EAST COOPER PHYSICIAN GROUP LLC below.

NPI Profile for
EAST COOPER PHYSICIAN GROUP LLC

NPI Number
1114893096
Enumeration Date

(about 8 months ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
EAST COOPER PHYSICIAN GROUP LLC
Primary location
2000 HOSPITAL DR
MOUNT PLEASANT, SC 29464-3764
Phone: (843) 881-0100 Fax:
3 Other location(s):
103 GARDINERS BAY DR
PONTE VEDRA, FL 32081-4406
Phone: (843) 881-0100
651 OLD BLUFF DR
PONTE VEDRA, FL 32081-0718
Phone: (843) 881-0100
24609 DEER TRACE DR
PONTE VEDRA BEACH, FL 32082-2114
Phone: (843) 881-0100
Mailing address
PO BOX 604408
CHARLOTTE, NC 28260-4408
Phone: Fax:
Organization Subpart
No
Authorized Official
LEEA WALTON
RCS MANAGER
Phone: (704) 316-6081
Updated
Certification Date
Jan 22, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2085R0202X
- Radiology / Diagnostic Radiology (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.