PALMETTO HEALTH (NPI# 1710137047) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710137047 |
| Entity Type | Organization |
| Organization Name | PALMETTO HEALTH |
| Other Organization Name | CLEMSON NEUROLOGY |
| Practice Address |
220 Keowee Trl Clemson SC 29631-1448 |
| Practice Telephone | 8646534071 |
| Practice Fax Number | 8646534074 |
| Mailing Telephone | 8646534071 |
| Mailing Fax Number | 8646534074 |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2008-09-23 |
| Authorized Official Name | MS. KENDALL DURHAM (OFFICE MANAGER) |
| Authorized Official Telephone | 8648555104 |
| Is Organization Subpart | Y |
| Parent Organization Name | PALMETTO HEALTH |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
SC | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Clemson Neurology | 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 |
220 KEOWEE TRL |
| City | CLEMSON |
| State | SC |
| Zip Code | 29631-1448 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699766436 | Clemson Neurology | Psychiatry & Neurology | 220 Keowee Trl, Clemson, SC 29631-1448 | 2005-11-01 |
| 1639544240 | Tanya Fuller-pellin | Nurse Practitioner | 220 Keowee Trl, Clemson, SC 29631-1448 | 2015-12-08 |
| 1740681147 | Tiffany Leah Stewart | Nurse Practitioner | 220 Keowee Trl, Clemson, SC 29631-1448 | 2014-09-05 |
| 1518199249 | Baptist Easley Hospital | Psychiatry & Neurology | 220 Keowee Trl, Clemson, SC 29631-1448 | 2009-08-13 |
| 1366642019 | Susan V. Breazeale | Psychiatry & Neurology | 220 Keowee Trl, Clemson, SC 29631-1448 | 2007-07-20 |
| 1023009701 | George Timothy Baxley | Psychiatry & Neurology | 220 Keowee Trl, Clemson, SC 29631-1448 | 2005-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063059038 | James Ryan Small | Specialist/Technologist | 212 Vista Cir, Clemson, SC 29631 | 2019-12-09 |
| 1811559883 | Cheyenne Leigh Reynolds | Specialist/Technologist | 100 Reeves Way, Clemson, SC 29631 | 2019-07-01 |
| 1912474792 | Andrea Bagley Stokes | Physical Therapist | 500-1 Old Greenville Hwy # 1, Clemson, SC 29631 | 2018-10-30 |
| 1114426178 | Intouch Pharmacy LLC | Pharmacy | 105 Wall Street, Suite 10b, Clemson, SC 29631 | 2018-02-06 |
| 1881117695 | Community Pharmacy Group, Inc. | Pharmacy | 143 Thomas Green Blvd, Clemson, SC 29631 | 2017-07-24 |
| 1295286276 | James Matthew Mills | Occupational Therapist | 101 Chapman Rd, Clemson, SC 29631 | 2016-10-14 |
| 1558769141 | Virginia Bridges Gaulin | Counselor | 209 Pendleton Rd Ste C, Clemson, SC 29631 | 2014-12-12 |
| 1437580628 | Amanda Martin Eubanks | Speech-Language Pathologist | 101 Chapman Road Suite 202, Clemson, SC 29631 | 2013-12-12 |
| 1437408499 | Fort Hill Family Dentistry, Pa | Clinic/Center | 124 Strode Circle, Clemson, SC 29631 | 2012-09-06 |
| 1942511738 | Theresa S Ritter | Counselor | 386 College Avenue, Suite A, Clemson, SC 29631 | 2010-06-25 |
| Find all providers in zip 29631 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699766436 | Clemson Neurology | Psychiatry & Neurology | 220 Keowee Trl, Clemson, SC 29631-1448 | 2005-11-01 |
| 1518199249 | Baptist Easley Hospital | Psychiatry & Neurology | 220 Keowee Trl, Clemson, SC 29631-1448 | 2009-08-13 |
| 1366642019 | Susan V. Breazeale | Psychiatry & Neurology | 220 Keowee Trl, Clemson, SC 29631-1448 | 2007-07-20 |
| 1073587390 | Jerry F Sherrill | Psychiatry & Neurology | 101 Chapman Hill Rd, Clemson, SC 29631 | 2006-02-14 |
| 1023009701 | George Timothy Baxley | Psychiatry & Neurology | 220 Keowee Trl, Clemson, SC 29631-1448 | 2005-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720693039 | Ppcp Specialty Physicians, LLC | Psychiatry & Neurology | 5500 Front St Ste 230, Summerville, SC 29486-7735 | 2020-09-14 |
| 1093323875 | Carolina Neurology & Neuroimaging LLC | Psychiatry & Neurology | 111 Shire Dr, Anderson, SC 29621-3675 | 2020-07-17 |
| 1891312799 | Kathryn Victoria Steverson | Psychiatry & Neurology | Prisma Health Medical Group Psychiatry Center, 15 Medical Park, Ste 141, Columbia, SC 29203 | 2020-06-26 |
| 1336764240 | Jal Ankeeth Ved | Psychiatry & Neurology | Prisma Health Medical Group Neurology, 8 Medical Park, Ste 420, Columbia, SC 29203 | 2020-06-16 |
| 1427608819 | Ppcp Specialty Physicians, LLC | Psychiatry & Neurology | 9221 University Blvd Ste 2d, North Charleston, SC 29406-9148 | 2019-09-17 |
| 1801454830 | Mark Joshua Rosenberg | Psychiatry & Neurology | 96 Jonathan Lucas St Csb 301, Msc 606, Charleston, SC 29425-0001 | 2019-06-04 |
| 1851955413 | David Alan Lockwood Jr. | Psychiatry & Neurology | Neurology Patient Care, 8 Medical Park, Ste 420, Columbia, SC 29203 | 2019-04-29 |
| 1164995700 | Amy Elizabeth Gallozzi | Psychiatry & Neurology | 531 Tributary Dr, Fort Lawn, SC 29714-8625 | 2019-01-07 |
| 1952896789 | Lauren Crawford | Psychiatry & Neurology | 96 Jonathan Street Suite 301, Charleston, SC 29425-0001 | 2018-06-25 |
| 1831610989 | Christopher Bruck Zust | Psychiatry & Neurology | 8 Medical Park Ste 420, Neurology Clinic, Columbia, SC 29203 | 2017-06-29 |
| Find all providers with the same taxonomy | ||||
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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.