ROPER SAINT FRANCIS PHYSICIANS NETWORK
Complete NPI Record 1245473545
Family Medicine in Mt Pleasant, SC

Active since April 16, 2009CLIA 42D0251220 · Microscopy
180 WINGO WAY, SUITE 207, MT PLEASANT, SC 29464(843) 884-5101(843) 606-7997 Get Directions

NPPES record last updated: April 12, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 12, 2026, Dec 16, 2019, Jul 9, 2018 and 3 more (6 updates tracked since 2016).

Complete NPI Dataset

This page contains the complete raw NPPES record for Roper Saint Francis Physicians Network (NPI 1245473545), a family medicine organization in Mt Pleasant, SC. All 56 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.

Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, Markdown or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.

Registry File Document Utilities
NPI: 1245473545
Field 1/56
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 2
Field 2/56
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN: Not available
Field 3/56
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
Provider Organization Name Legal Business Name: ROPER SAINT FRANCIS PHYSICIANS NETWORK
Field 4/56
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider Other Organization Name: Not available
Field 5/56
Other name by which the organization provider is or has been known.
Provider Other Organization Name Type Code: 6
Field 6/56
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address: PO BOX 632516
Field 7/56
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City Name: CINCINNATI
Field 8/56
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: OH
Field 9/56
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code: 452632516
Field 10/56
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Country Code If outside U S : US
Field 11/56
The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
Provider Business Mailing Address Telephone Number: 8884720043
Field 12/56
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number: 5136534122
Field 13/56
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Provider First Line Business Practice Location Address: 180 WINGO WAY
Field 14/56
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location Address: SUITE 207
Field 15/56
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: MT PLEASANT
Field 16/56
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: SC
Field 17/56
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 29464
Field 18/56
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
Field 19/56
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 8438845101
Field 20/56
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 8436067997
Field 21/56
The fax number associated with the location address of the provider being identified.
Authorized Official Last Name: OLIVERIO
Field 24/56
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: ROBERT
Field 25/56
The first name of the authorized official.
Authorized Official Middle Name: R.
Field 26/56
The middle name of the authorized official.
Authorized Official Title or Position: VP/CEO RSFPP
Field 27/56
The title or position of the authorized official.
Authorized Official Telephone Number: 8437242903
Field 28/56
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 332B00000X
Field 29/56
This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: N
Field 30/56
This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Healthcare Provider Taxonomy Code 2: 207Q00000X
Field 31/56
This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 2: Y
Field 32/56
This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Other Provider Identifier 1: GP5157
Field 33/56
An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
Other Provider Identifier Type Code 1: 05
Field 34/56
A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
Other Provider Identifier State 1: SC
Field 35/56
The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
Other Provider Identifier 2: 623805300
Field 36/56
An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
Other Provider Identifier Type Code 2: 01
Field 37/56
A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
Other Provider Identifier State 2: SC
Field 38/56
The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
Other Provider Identifier Issuer 2: DOL
Field 39/56
The name of the organization, agency, or health plan that assigned the additional provider identifier. This identifies who issued the number linked to Other Provider Identifier 1 (for example, a state Medicaid agency, Medicare, or a private insurance company).
Other Provider Identifier 3: 047
Field 40/56
An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
Other Provider Identifier Type Code 3: 01
Field 41/56
A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
Other Provider Identifier State 3: SC
Field 42/56
The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
Other Provider Identifier Issuer 3: BCBS SC SUFFIX
Field 43/56
The name of the organization, agency, or health plan that assigned the additional provider identifier. This identifies who issued the number linked to Other Provider Identifier 1 (for example, a state Medicaid agency, Medicare, or a private insurance company).
Other Provider Identifier 4: 106
Field 44/56
An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
Other Provider Identifier Type Code 4: 01
Field 45/56
A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
Other Provider Identifier State 4: SC
Field 46/56
The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
Other Provider Identifier Issuer 4: BLUECHOICE SUFFXI
Field 47/56
The name of the organization, agency, or health plan that assigned the additional provider identifier. This identifies who issued the number linked to Other Provider Identifier 1 (for example, a state Medicaid agency, Medicare, or a private insurance company).
Other Provider Identifier 5: DP0704
Field 48/56
An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
Other Provider Identifier Type Code 5: 01
Field 49/56
A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
Other Provider Identifier State 5: SC
Field 50/56
The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
Other Provider Identifier Issuer 5: RAILROAD MEDICARE GROUP PTAN
Field 51/56
The name of the organization, agency, or health plan that assigned the additional provider identifier. This identifies who issued the number linked to Other Provider Identifier 1 (for example, a state Medicaid agency, Medicare, or a private insurance company).
Is Organization Subpart: N
Field 52/56
Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.
Authorized Official Name Prefix Text: DR.
Field 53/56
The prefix used in the name of the authorized official associated with the provider's NPI record. Examples include Mr., Ms., Mrs., Dr., or other common professional or personal prefixes.
Authorized Official Name Suffix Text: JR.
Field 54/56
The suffix used in the name of the authorized official associated with the provider's NPI record. Examples include Jr., Sr., II, III, or professional designations such as PhD, MD, or Esq.
Healthcare Provider Taxonomy Group 2: 193400000X SINGLE SPECIALTY GROUP
Field 55/56
Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.

Other Organization Names 1

Additional business and trade names this provider has on file with the NPPES registry.

Roper St. Francis Physician Partners Primary Care Doing Business As
Name 1/1
Doing Business As: A trade name or operating name under which an organization provides services, distinct from its registered legal business name.

Other Provider Identifiers 5

Legacy and payer-issued identifiers reported to the NPPES registry for this provider.

GP5157 Medicaid
Identifier 1/5
State: SC
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
623805300 Other
Identifier 2/5
State: SC · Issuer: Dol
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
047 Other
Identifier 3/5
State: SC · Issuer: Bcbs Sc Suffix
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
106 Other
Identifier 4/5
State: SC · Issuer: Bluechoice Suffxi
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
DP0704 Other
Identifier 5/5
State: SC · Issuer: Railroad Medicare Group Ptan
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
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