PALMETTO PRIMARY CARE PHYSICIANS (NPI# 1528557055) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528557055 |
| Entity Type | Organization |
| Organization Name | PALMETTO PRIMARY CARE PHYSICIANS |
| Practice Address |
710 Rabon Rd Ste 202 Columbia SC 29203 |
| Mailing Address |
201 Sigma Dr Ste 100 Summerville SC 29486-7722 |
| Practice Telephone | 8036362121 |
| Practice Fax Number | 8036269355 |
| Mailing Telephone | 8436956071 |
| Mailing Fax Number | 8435695881 |
| Enumeration Date | 2018-05-10 |
| 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 | GP8376 | 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 |
710 RABON RD STE 202 |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932193489 | Kimberly B Williams | Family Medicine | 710 Rabon Rd Ste 202, Columbia, SC 29203 | 2005-09-09 |
| 1194775866 | Wendy L Lykes | Nurse Practitioner | 710 Rabon Rd Ste 202, Columbia, SC 29203 | 2006-05-11 |
| 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 | 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 |
|---|---|---|---|---|
| 1447868005 | Brittany Mechelle Waterworth | Family Medicine | 3700 I 70 Dr Se Ste 106, Columbia, MO 65201-6587 | 2020-07-20 |
| 1730706839 | John James Gannon | Family Medicine | Prisma Health Medical Group Family Medicine, 3209 Colonial Drive, Columbia, SC 29203 | 2020-07-06 |
| 1053938852 | Garrison Glenn Rice | Family Medicine | Prisma Health Medical Group Family Medical Center, 3209 Colonial Drive, Columbia, SC 29203 | 2020-06-29 |
| 1457977563 | Jenny Tatiana Gonzalez Guzman | Family Medicine | Prisma Health Family Medical Center, 3209 Colonial Drive, Columbia, SC 29203 | 2020-06-24 |
| 1942825500 | Jarvis Jamal Johnson | Family Medicine | Prisma Health Family Medicine Center, 3209 Colonial Drive, Columbia, SC 29203 | 2020-06-10 |
| 1386268183 | Nicolas Anthony Limogiannis | Family Medicine | Prisma Health Medical Group Family Medicine Center, 3209 Colonial Drive, Columbia, SC 29203 | 2020-06-08 |
| 1730724220 | Luci Lee Redman Cassella | Family Medicine | 8900 Columbia 100 Parway Suite G, Columbia, MD 21045 | 2019-11-08 |
| 1275177420 | Palmetto Primary Care Physicians | Family Medicine | 1415 Blanding St Ste 2, Columbia, SC 29201-2922 | 2019-10-31 |
| 1558919852 | Synergos Medical, LLC | Family Medicine | 1703 Oak Cliff Pl, Columbia, MO 65203-4719 | 2019-08-29 |
| 1972156982 | Maury Regional Medical Group, Inc | Family Medicine | 2478 Nashville Hwy Ste A, Columbia, TN 38401-0634 | 2019-07-18 |
| 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.