Organization Active NPI

Palmetto Language & Speech Center, LLC

  • Speech-Language Pathologist
  • Lexington, SC
National Provider Identifier
1063586493
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1522 Issued in SC
Legal business name
PALMETTO LANGUAGE & SPEECH CENTER, LLC
Practice address
109 A Vista Oaks Drive
Lexington, SC 29072
Phone
(803) 356-9833
Fax
(803) 996-0548
NPI assigned
Nov 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. June K Maranville, MSP, CCC-SLP
Title
Center Director
Phone
(803) 356-9833

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 1522 SC Primary

Addresses

Primary practice location

109 A Vista Oaks Drive
Lexington, SC 29072

Mailing address

109 A Vista Oaks Drive
Lexington, SC 29072
Phone (803) 356-9833

Other identifiers 2

IdentifierTypeStateIssuer
SAO175MedicaidSC
1740381573OtherSCINDIVIDUAL NPI NUMBER

National Provider Directory

National Provider Directory

Locations

109 Vista Oaks Dr
#A
Lexington, SC 29072
Phone (803) 356-9833

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1163808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063586493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 A VISTA OAKS DRIVE",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "29072",
            "telephone_number": "803-356-9833",
            "fax_number": "803-996-0548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 A VISTA OAKS DRIVE",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "29072",
            "telephone_number": "803-356-9833",
            "fax_number": "803-996-0548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO LANGUAGE & SPEECH CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARANVILLE",
        "authorized_official_first_name": "JUNE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CENTER DIRECTOR",
        "authorized_official_telephone_number": "803-356-9833",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSP, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "1522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SAO175",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI NUMBER",
            "identifier": "1740381573",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.