Palmetto Primary Care Physicians, LLC

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

31768 Issued in SC

Legal business name

PALMETTO PRIMARY CARE PHYSICIANS, LLC

Practice address

1101 Old Trolley Rd
Ste 300
Summerville, SC 29485-5293

Phone

(843) 376-2670

Fax

(843) 376-2790

NPI assigned

Nov 22, 2013

Organization subpart

No

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

Authorized official

Name

Scott Turner

Title

Ceo

Phone

(843) 695-6071

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Palmetto - Endocrinology Doing business as

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Practitioners 4

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

• Allen T Cooke, NP

  • Family Nurse Practitioner
  • Summerville, SC
  • NPI 1851909162
  NPD
• Emily Jean Kachelmeyer, APRN, CNS

  • Gerontology Clinical Nurse Specialist
  • Summerville, SC
  • NPI 1396466991
  NPD
• Ashley Matkins, PA-C

  • Physician Assistant
  • Mt Pleasant, SC
  • NPI 1306535521
  NPD
• Allison Fain Davis, APRN

  • Adult Health Nurse Practitioner
  • Las Vegas, NV
  • NPI 1144579806
  NPD

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

{
    "created_epoch": "1385078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622505600000",
    "number": "1023448487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 530062",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303530062",
            "telephone_number": "843-695-6071",
            "fax_number": "843-569-5881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 OLD TROLLEY RD",
            "address_2": "STE 300",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294855293",
            "telephone_number": "843-376-2670",
            "fax_number": "843-376-2790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO PRIMARY CARE PHYSICIANS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-22",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A",
        "authorized_official_last_name": "TURNER",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "843-695-6071"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "SC",
            "license": "31768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP6484",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palmetto - Endocrinology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Palmetto - Endocrinology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Palmetto Primary Care Physicians, LLC
• Palmetto Primary Care Physicians, LLC
• Palmetto Primary Care Physicians, LLC
• Palmetto Primary Care Physicians, LLC
• Palmetto Primary Care Physicians, LLC

• All providers in Summerville, SC
• Endocrinology, Diabetes & Metabolism Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2021; 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.