Organization Active NPI

Palmetto Wellness and Weightloss MD

  • Internal Medicine Physician
  • Aiken, SC
National Provider Identifier
1013332600
Registry record updated Feb 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
18256 Issued in SC
Legal business name
PALMETTO WELLNESS AND WEIGHTLOSS MD
Practice address
1397 Silver Bluff Rd
Suite 200
Aiken, SC 29803-8860
Phone
(803) 646-5003
Fax
(803) 226-0480
NPI assigned
Feb 19, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jennifer Ashley Harmon, LPN
Title
Office Manager
Phone
(803) 646-5003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 18256 SC Primary

Addresses

Primary practice location

1397 Silver Bluff Rd
Suite 200
Aiken, SC 29803-8860

Mailing address

1397 Silver Bluff Rd
Suite 200
Aiken, SC 29803-8860
Phone (803) 646-5003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140422000953 SC Part B Supplier - Clinic/Group Practice 2860624087 Receives reassigned benefits from 1 practitioner
Practice locations: Aiken, SC

National Provider Directory

National Provider Directory

Locations

1397 Silver Bluff Rd
Ste 200
Aiken, SC 29803
Phone (803) 646-5003

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1392768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392768000000",
    "number": "1013332600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1397 SILVER BLUFF RD",
            "address_2": "SUITE 200",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298038860",
            "telephone_number": "803-646-5003",
            "fax_number": "803-226-0480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1397 SILVER BLUFF RD",
            "address_2": "SUITE 200",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298038860",
            "telephone_number": "803-646-5003",
            "fax_number": "803-226-0480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO WELLNESS AND WEIGHTLOSS MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-19",
        "last_updated": "2014-02-19",
        "status": "A",
        "authorized_official_last_name": "HARMON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "ASHLEY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "803-646-5003",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "18256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiken, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.