Palmetto Vascular Diagnostic LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

PALMETTO VASCULAR DIAGNOSTIC LLC

Practice address

2020 McQueen Blvd
Orangeburg, SC 29118-1200

Phone

(803) 308-1524

Fax

(803) 937-6520

NPI assigned

Jun 26, 2006

Organization subpart

No

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

Authorized official

Name

Robert E Myers

Title

Owner

Phone

(803) 308-1524

Specialties & licenses 2

Addresses

Other identifiers 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jehad S Abdalla, M.D.

  • Infectious Disease Physician
  • Orangeburg, SC
  • NPI 1912095738
  NPD (past)
• Jeremy W Young, MD

  • Diagnostic Radiology Physician
  • Orangeburg, SC
  • NPI 1912958950

  Diagnostic Radiology

  NPD (past)

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380672000000",
    "number": "1013944206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 MCQUEEN BLVD",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291181200",
            "telephone_number": "803-308-1524",
            "fax_number": "803-937-6520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 MCQUEEN BLVD",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291181200",
            "telephone_number": "803-308-1524",
            "fax_number": "803-937-6520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO VASCULAR DIAGNOSTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-26",
        "last_updated": "2013-10-02",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-308-1524"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2471V0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Vascular Sonography",
            "state": "SC",
            "license": "33630",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SL0071",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Palmetto Medical Transportation, LLC
• Palmetto Moon Anesthesia, LLC
• Palmetto Nephrology PA
• Palmetto Primary Care Physicians, LLC
• Palmetto Urology PA
• Christy Parker
• Dhara Patel, PHARMD
• Mehul Patel, DPT
• Rubin Gopal Patel, MD
• Ellen Fay Patrick, PT

• All providers in Orangeburg, SC
• Diagnostic Radiology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.