Provider Demographics
| NPI: | 1497117378 |
|---|---|
| Name: | ARCIS HEALTHCARE, LLC |
| Entity Type: | Organization |
| Organization Name: | ARCIS HEALTHCARE, LLC |
| Other - Org Name: | LOWCOUNTRY ORTHOPAEDICS & SPORTS MEDICINE |
| Other - Org Type: | Doing Business As |
| Authorized Official - Title/Position: | CEO |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | DON |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | BECKER |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 843-797-5050 |
| Mailing Address - Street 1: | PO BOX 12810 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | BELFAST |
| Mailing Address - State: | ME |
| Mailing Address - Zip Code: | 04915-4019 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 866-528-1376 |
| Mailing Address - Fax: | 843-797-3633 |
| Practice Address - Street 1: | 899 ISLAND PARK DR |
| Practice Address - Street 2: | SUITE 200 |
| Practice Address - City: | DANIEL ISLAND |
| Practice Address - State: | SC |
| Practice Address - Zip Code: | 29492-8112 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 843-797-5050 |
| Practice Address - Fax: | 843-797-3633 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2016-03-22 |
| Last Update Date: | 2017-08-04 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| SC | 204R00000X, 207X00000X, 207XS0106X, 207XS0114X, 207XS0117X, 207XX0004X, 207XX0005X, 208100000X, 2081P2900X, 363A00000X, 363AM0700X, 363AS0400X, 363LA2200X, 363LF0000X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty | |
| No | 204R00000X | Allopathic & Osteopathic Physicians | Electrodiagnostic Medicine | Group - Multi-Specialty | |
| No | 207XS0106X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Hand Surgery | Group - Multi-Specialty |
| No | 207XS0114X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Adult Reconstructive Orthopaedic Surgery | Group - Multi-Specialty |
| No | 207XS0117X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Surgery of the Spine | Group - Multi-Specialty |
| No | 207XX0004X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Foot and Ankle Surgery | Group - Multi-Specialty |
| No | 207XX0005X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Sports Medicine | Group - Multi-Specialty |
| No | 208100000X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Group - Multi-Specialty | |
| No | 2081P2900X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Pain Medicine | Group - Multi-Specialty |
| No | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Group - Multi-Specialty | |
| No | 363AM0700X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical | Group - Multi-Specialty |
| No | 363AS0400X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical | Group - Multi-Specialty |
| No | 363LA2200X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | Group - Multi-Specialty |
| No | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| SC | DU4331 | Other | RAILROAD MEDICARE |
| SC | 45168 | Other | GROUP MULTIPLAN ID |
| SC | GP6337 | Medicaid | |
| SC | DU4331 | Other | RAILROAD MEDICARE |
