PALMETTO PRIMARY CARE PHYSICIANS (NPI# 1740846138) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740846138 |
| Entity Type | Organization |
| Organization Name | PALMETTO PRIMARY CARE PHYSICIANS |
| Practice Address |
3020 Sunset Blvd Ste 101 West Columbia SC 29169-3494 |
| Mailing Address |
201 Sigma Dr #100 Summerville SC 29486-7722 |
| Practice Telephone | 8037915680 |
| Practice Fax Number | 8037911680 |
| Mailing Telephone | 8436956071 |
| Mailing Fax Number | 8435695879 |
| Enumeration Date | 2019-05-13 |
| Last Update Date | 2019-10-31 |
| Authorized Official Name | BRENDA REEVE (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 8438203403 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | GP9032 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275177420 | Palmetto Primary Care Physicians | Family Medicine | 1415 Blanding St Ste 2, Columbia, SC 29201-2922 | 2019-10-31 |
| 1326501834 | Palmetto Primary Care Physicians | Internal Medicine | 710 Rabon Rd Ste 203, Columbia, SC 29203-8903 | 2019-04-11 |
| 1700354164 | Palmetto Primary Care Physicians | Clinic/Center | 2500 Elms Center Rd Ste B, North Charleston, SC 29406-9844 | 2018-11-05 |
| 1023428745 | Palmetto Primary Care Physicians | Family Medicine | 202 Ridge St, Saint George, SC 29477-2446 | 2014-05-02 |
| 1497075733 | Palmetto Primary Care Physicians | Family Medicine | 300 W 4th North St, Summerville, SC 29483-6550 | 2010-06-09 |
| 1568405926 | Palmetto Primary Care Physicians | Family Medicine | 404 N Pine St, Summerville, SC 29483-6557 | 2006-06-14 |
| 1245271261 | Palmetto Primary Care Physicians | Family Medicine | 7 South Alliance Drive, Ste 201a, Goose Creek, SC 29445 | 2006-06-09 |
| 1851332951 | Palmetto Primary Care Physicians | Nutritionist | 213 West 4th North Street, Summerville, SC 29483 | 2006-06-09 |
| 1659311165 | Palmetto Primary Care Physicians | Nutritionist | 1401 Main St., Bonneau, SC 29431 | 2006-06-07 |
| 1104866623 | Palmetto Primary Care Physicians | Family Medicine | 401 N Live Oak Dr, Ste. B, Moncks Corner, SC 29461-5603 | 2006-06-07 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PALMETTO PRIMARY CARE PHYSICIANS, L.L.C. | 2500 Elms Center Rd, North Charleston, SC 29406-9844 |
| Street Address |
3020 SUNSET BLVD STE 101 |
| City | WEST COLUMBIA |
| State | SC |
| Zip Code | 29169-3494 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699745141 | Tasha Matthews Boone | Family Medicine | 3020 Sunset Blvd Ste 101, West Columbia, SC 29169 | 2006-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457960726 | Jerry Scott Oreilly | Physical Therapy Assistant | 100 Dreher Rd, Suite 100, West Columbia, SC 29169 | 2020-07-23 |
| 1134759921 | A&m Medical, LLC | Durable Medical Equipment & Medical Supplies | 1053 Sunset Boulevard, West Columbia, SC 29169 | 2020-01-21 |
| 1750946067 | First Physical Therapy, LLC | Clinic/Center | 100 Dreher Rd., Suite 100, West Columbia, SC 29169 | 2019-05-02 |
| 1295217545 | Tynaka Kwans Wilson | Nurse Practitioner | Sc House Calls Inc, 1053 Center Street, West Columbia, SC 29169 | 2018-09-04 |
| 1588183826 | Kimberly Jane Jennings | Registered Nurse | 1052 Center Street, Sc House Calls Inc, West Columbia, SC 29169 | 2017-09-19 |
| 1164943213 | Jacob Luke Wayland | Emergency Medicine | Lexington Medical Center-emergency Medicine Dept, 2720 Sunset Blvd, West Columbia, SC 29169 | 2017-06-29 |
| 1740721232 | Heather Detwiler | Physical Therapy Assistant | 2705 Leaphart Rd., Carolina Gardens, West Columbia, SC 29169 | 2017-03-16 |
| 1588110761 | Virginia I Hall | Nurse Practitioner | 2720 Susnet Blvd, West Columbia, SC 29169 | 2016-08-29 |
| 1215395744 | Stacey Khalifa | Social Worker | 160 Medical Cir Fl 1, West Columbia, SC 29169 | 2016-01-28 |
| 1407252331 | Sandy Frye Boone | Counselor | 2318 Sunset Blvd # 2a, West Columbia, SC 29169 | 2014-11-04 |
| Find all providers in zip 29169 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154928570 | Lexington Health Inc | Family Medicine | 146 E Hospital Dr Ste 500, West Columbia, SC 29169-4842 | 2020-10-08 |
| 1699244178 | Victoria G Andes | Family Medicine | 295 Marabou Cir, West Columbia, SC 29169-4748 | 2018-11-14 |
| 1457379901 | Lexington County Health Services District, Inc. | Family Medicine | 3314 Platt Springs Rd, West Columbia, SC 29170 | 2006-07-17 |
| 1578521076 | Philip C Honig | Family Medicine | 2836 Augusta Rd, West Columbia, SC 29170-3323 | 2006-05-03 |
| 1437113198 | Earl W Hutchins | Family Medicine | 3020 Sunset Blvd Ste 102, West Columbia, SC 29169 | 2006-04-12 |
| 1699745141 | Tasha Matthews Boone | Family Medicine | 3020 Sunset Blvd Ste 101, West Columbia, SC 29169 | 2006-01-26 |
| 1346873437 | Andrea Nicole Todd | Family Medicine | 513 S Columbia Dr, West Columbia, TX 77486-3025 | 2020-02-17 |
| 1063067270 | Holly Davis | Family Medicine | 1053 Center Street, Sc House Calls Inc, West Columbia, SC 29169 | 2019-08-05 |
| 1134787641 | Select Physicians Care | Family Medicine | 1 Still Hopes Dr, West Columbia, SC 29169-7164 | 2019-05-30 |
| 1871072827 | Amnesty Health Group LLC | Family Medicine | 3020 Sunset Blvd Ste 102, West Columbia, SC 29169-3494 | 2018-08-10 |
| Find all providers in WEST COLUMBIA | ||||
| City | WEST COLUMBIA |
| Zip Code | 29169 |
Please comment or provide details below to improve the information on PALMETTO PRIMARY CARE PHYSICIANS.
| 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.