PALMETTO HEALTH (NPI# 1104370188) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104370188 |
| Entity Type | Organization |
| Organization Name | PALMETTO HEALTH |
| Other Organization Name | PALMETTO HEALTH DENTAL CLINIC |
| Practice Address |
10 Richland Medical Park Dr Suite A Columbia SC 29203-6864 |
| Mailing Address |
Po Box 402145 Atlanta GA 30384-2145 |
| Practice Telephone | 8034346567 |
| Practice Fax Number | 8034346299 |
| Mailing Telephone | 8032967303 |
| Mailing Fax Number | 8032967330 |
| Enumeration Date | 2016-08-08 |
| Last Update Date | 2016-08-08 |
| Authorized Official Name | DARRELL C COVEN (DIRECTOR, AMBULATORY SERVICES FINAN) |
| Authorized Official Telephone | 8032967301 |
| Is Organization Subpart | Y |
| Parent Organization Name | PALMETTO HEALTH |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Palmetto Health Dental Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891232880 | Palmetto Health | Clinic/Center | 3010 Farrow Rd Ste 110, Columbia, SC 29203-7603 | 2017-01-27 |
| 1003351859 | Palmetto Health | General Acute Care Hospital | 808 Kawana Rd, Columbia, SC 29205-2033 | 2017-01-04 |
| 1043688120 | Palmetto Health | Rehabilitation Unit | 3600 Forest Drive-suite 101, Columbia, SC 29204-0000 | 2015-09-08 |
| 1033514120 | Palmetto Health | Internal Medicine | 6 Richland Medical Park Dr, Suite 2100, Columbia, SC 29203-6864 | 2014-10-31 |
| 1851642458 | Palmetto Health | Family Medicine | 100 Palmetto Health Parkway, Suite 220, Columbia, SC 29212-1755 | 2012-09-24 |
| 1932464476 | Palmetto Health | Counselor | 2721 Dutch Fork Rd, Chapin, SC 29036-8565 | 2012-07-11 |
| 1417211954 | Palmetto Health | Ambulance | 10 Medical Park Drive, Columbia, SC 29203-0000 | 2012-06-29 |
| 1164796306 | Palmetto Health | Pediatrics | 7 Medical Park Drive, Suite 7215, Columbia, SC 29203-6863 | 2012-03-06 |
| 1134453863 | Palmetto Health | Counselor | 1001 Highway 378 W, Lexington, SC 29072-8321 | 2009-09-29 |
| 1124279872 | Palmetto Health | Family Medicine | 300 W. Front St, Liberty, SC 29657-1012 | 2008-09-30 |
| Street Address |
10 RICHLAND MEDICAL PARK DR SUITE A |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29203-6864 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396833612 | Robert M. Punch | Pharmacist | 10 Richland Medical Park Dr, Columbia, SC 29203-6892 | 2006-10-11 |
| 1548889314 | Sharon Montana Housand | Dentist | 10 Richland Medical Park Dr, Columbia, SC 29203-6864 | 2020-04-13 |
| 1841774718 | Laura Mansfield | Pharmacist | 10 Richland Medical Park Dr, Columbia, SC 29203-6864 | 2018-09-18 |
| 1073009544 | Laura Baker Straw | Pharmacist | 10 Richland Medical Park Dr, Columbia, SC 29203-6864 | 2018-07-07 |
| 1467943597 | Christopher Olsen | Dentist | 10 Richland Medical Park Dr, Columbia, SC 29203-6864 | 2018-05-24 |
| 1134642630 | Margaret Lee Hansen | Pharmacist | 10 Richland Medical Park Dr, Columbia, SC 29203-6864 | 2017-07-18 |
| 1629590435 | Victoria Hetherington | Pharmacist | 10 Richland Medical Park Dr, Columbia, SC 29203-6864 | 2017-07-13 |
| 1164873998 | Margaret Mccall Brennan | Pharmacist | 10 Richland Medical Park Dr, Columbia, SC 29203-6864 | 2016-06-22 |
| 1407217185 | Brett Renee Stroud | Pharmacist | 10 Richland Medical Park Dr, Columbia, SC 29203-6864 | 2016-03-09 |
| 1558722306 | Nicole Bookstaver | Pharmacist | 10 Richland Medical Park Dr, Columbia, SC 29203-6864 | 2016-03-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475284 | Matthew Leon Brigmon | Surgery | 2 Richland Medical Park, Suite 300, Columbia, SC 29203 | 2020-10-23 |
| 1730706839 | John James Gannon | Family Medicine | Prisma Health Medical Group Family Medicine, 3209 Colonial Drive, Columbia, SC 29203 | 2020-07-06 |
| 1790302362 | Klariz Teves Tucker | Internal Medicine | Internal Medcine Center, 1801 Sunset Drive, Columbia, SC 29203 | 2020-06-30 |
| 1811514482 | Esther Ruth Swan | Psychiatry & Neurology | Prisma Health General Psychiatry Center, 15 Medical Park, Ste 141, Columbia, SC 29203 | 2020-06-30 |
| 1447877014 | Jordan Kaitlyn Merrels | Psychiatry & Neurology | Prisma Health Medical Group General Psychiatry, 15 Medical Park, Ste 141, Columbia, SC 29203 | 2020-06-30 |
| 1306463187 | Jessica Leigh Watson | Psychiatry & Neurology | Prisma Health General Psychiatry, 15 Medical Park, Ste 141, Columbia, SC 29203 | 2020-06-29 |
| 1053938852 | Garrison Glenn Rice | Family Medicine | Prisma Health Medical Group Family Medical Center, 3209 Colonial Drive, Columbia, SC 29203 | 2020-06-29 |
| 1053938977 | Rachel Ellen Harper | Obstetrics & Gynecology | The Womens Center, 1801 Sunset Drive, Columbia, SC 29203 | 2020-06-26 |
| 1609493592 | Elizabeth Marie Kern | Orthopaedic Surgery | Prisma Health Medical Group Orthopedic Center, 2 Medical Park, Ste 105, Columbia, SC 29203 | 2020-06-26 |
| 1891312799 | Kathryn Victoria Steverson | Psychiatry & Neurology | Prisma Health Medical Group Psychiatry Center, 15 Medical Park, Ste 141, Columbia, SC 29203 | 2020-06-26 |
| Find all providers in zip 29203 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740810845 | Akeso Columbia Office LLC | Dentist | 6798 Oak Hall Ln Ste A-1, Columbia, MD 21045-4892 | 2020-01-17 |
| 1679809958 | Mathew K Woodward | Dentist | 5397 Twin Knolls Rd Ste 18, Columbia, MD 21045-3256 | 2009-10-21 |
| 1679730709 | Antoine Gerard Johnson | Dentist | 8860 Columbia 100 Pkwy Ste 308, Columbia, MD 21045-2298 | 2008-05-16 |
| 1497829311 | Darren Richard Cross | Dentist | 611 Oneil Ct, Columbia, SC 29223-7656 | 2006-11-20 |
| 1427121078 | Joseph John Krupa IIi | Dentist | 3304 Forest Dr, Columbia, SC 29204-4024 | 2006-11-15 |
| 1194748285 | Paul Edward Cullum | Dentist | 105 Berrywood Dr, Columbia, TN 38401-6409 | 2006-07-26 |
| 1508885682 | Michael Illar Muul | Dentist | 6798 Oak Hall Ln, Suite A1, Columbia, MD 21045-4892 | 2006-07-19 |
| 1952353732 | James Winston Strider Jr. | Dentist | 9310 Two Notch Road, Columbia, SC 29223 | 2006-05-17 |
| 1952376964 | Timothy Thomas Coyle | Dentist | 3015 S Providence Rd, Suite 5, Columbia, MO 65203 | 2006-02-22 |
| 1497720841 | George Alan Hurwitz | Dentist | 10782 Hickory Ridge Rd, Columbia, MD 21044-3646 | 2006-02-21 |
| Find all providers in COLUMBIA | ||||
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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.