SJC ONCOLOGY SERVICES-SOUTH CAROLINA, LLC (NPI# 1306055025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306055025 |
| Entity Type | Organization |
| Organization Name | SJC ONCOLOGY SERVICES-SOUTH CAROLINA, LLC |
| Other Organization Name | BEAUFORT HILTON HEAD RADIATION ONCOLOGY CENTER, LP |
| Practice Address |
100 Buckwalter Place Blvd Ste 150 Bluffton SC 29910-5154 |
| Mailing Address |
Po Box 11407 Dept 1623 Birmingham AL 35246-1623 |
| Practice Telephone | 8438367120 |
| Practice Fax Number | 8438367137 |
| Mailing Telephone | 9123521700 |
| Mailing Fax Number | 9123521066 |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2020-03-09 |
| Authorized Official Name | MR. GREGORY J SCHAACK (CFO/VP, FINANCE) |
| Authorized Official Telephone | 9128196162 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
Allopathic & Osteopathic Physicians | ||
| N | 2086X0206X |
Surgery Specialization: Surgical Oncology |
Allopathic & Osteopathic Physicians | ||
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000360533A | 05 | |
| SC | GP5359 | 05 | |
| SC | RAILROAD MEDICARE | CC0817 | 01 |
| SC | 114450 | 05 |
| Other Name | Type Code |
|---|---|
| Beaufort Hilton Head Radiation Oncology Center, LP | Former Legal Business Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 300 New River Pkwy Ste 26, Hardeeville, SC 299274546 | 8432082895 | 8432082896 |
| 25 Hospital Center Blvd., Suite 101, Hilton Head Island, SC 299262738 | 8436896490 | 8436896479 |
| 100 Buckwalter Place Blvd Ste 120, Bluffton, SC 299105154 | 8438367120 | 8438158014 |
| Street Address |
100 BUCKWALTER PLACE BLVD STE 150 |
| City | BLUFFTON |
| State | SC |
| Zip Code | 29910-5154 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053912444 | Publix Super Markets, Inc | Durable Medical Equipment & Medical Supplies | 2501 May River Crossing, Bluffton, SC 29910 | 2020-11-03 |
| 1447873815 | Chatham Orthopaedic Associates, Pa | Orthopaedic Surgery | 4812 Bluffton Parkway, Bluffton, SC 29910 | 2020-05-20 |
| 1831682327 | Tattnall Hospital Company LLC | Occupational Therapist | 8201 Pinellas Dr, Bluffton, SC 29910 | 2018-06-11 |
| 1437647070 | Health Performance Systems LLC | Massage Therapist | 20 Towne Dr Ste 102, Bluffton, SC 29910 | 2018-04-30 |
| 1659880540 | Jessica Partain | Assistant Behavior Analyst | 254 Red Cedar St Ste 11, Bluffton, SC 29910 | 2017-09-24 |
| 1760901177 | Thomas Ross Miller | Specialist/Technologist | 7 Independence Place, Bluffton, SC 29910 | 2017-09-18 |
| 1982124400 | Caitlin Diane Harvey | Behavioral Analyst | 4 Oliver Ct Ste 105, Bluffton, SC 29910 | 2017-06-26 |
| 1770011041 | Michael Ross Reeves | Physical Therapist | 38 Sheridan Park Cir Ste C, Bluffton, SC 29910 | 2017-05-31 |
| 1982141750 | Jebediah S. Christy, D.d.s. - Blufton, Pllc | Dentist | 1135 Fording Island Rd, Bluffton, SC 29910 | 2017-01-31 |
| 1225589377 | Kathryn Hope | Occupational Therapist | 31 Innovation Dr Ste 100, Bluffton, SC 29910 | 2016-10-24 |
| Find all providers in zip 29910 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447862255 | Broad River Oncology LLC | Radiology | 122 Okatie Center Blvd N, Bluffton, SC 29909-3750 | 2020-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659885754 | Providence Physician Practices, LLC | Radiology | 114 Gateway Corporate Blvd Ste 440, Columbia, SC 29203-9785 | 2017-11-28 |
| 1497045058 | Charles Eric Wooten | Radiology | 805 Pamplico Hwy Ste A315, Florence, SC 29505-6056 | 2011-04-15 |
| 1174769764 | Beaufort County Memorial Hospital | Radiology | 989 Ribaut Rd Ste 130, Beaufort, SC 29902 | 2009-01-02 |
| 1255518734 | Paul Anthony Saconn | Radiology | 122 Okatie Center Blvd N, Okatie, SC 29909-3750 | 2008-01-27 |
| 1508042201 | Newberry Oncology Associates | Radiology | 298 Commerce Dr., Newberry, SC 29108 | 2008-01-14 |
| 1972624484 | James Fyffe Mcnab | Radiology | 1680 Ribaut Raod, Ste A, Port Royal, SC 29935-2029 | 2007-04-02 |
| 1568516383 | Edward William Duffy Jr. | Radiology | 130 North Washington Street, Sumter, SC 29150 | 2007-01-22 |
| 1811908064 | Vipul V Thakkar | Radiology | 228 S Herlong Ave, Rock Hill, SC 29732-1158 | 2006-08-11 |
| 1285645937 | Eduard Dvorak | Radiology | 30494 435th Ave, Utica, SC 57067-5905 | 2006-08-10 |
| 1013947589 | Larry Douglas Grubb | Radiology | 130 N Washington St, Sumter, SC 29150-4920 | 2006-07-03 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.