Palmetto Health

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PALMETTO HEALTH

Practice address

1316 N Lake Dr
Lexington, SC 29072-7653

Phone

(803) 358-1191

NPI assigned

Oct 17, 2011

Organization subpart

Yes

Parent organization

PALMETTO HEALTHAs reported in NPPES

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

Authorized official

Name

Mr. Darrell C Coven

Title

Director, Ambulatory Servicesfinanc

Phone

(803) 296-7301

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lakeview Family Medicine Doing business as

Part of

Markowitz and Associates

Locations

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

{
    "created_epoch": "1318809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439769600000",
    "number": "1093090482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 402145",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303842145",
            "telephone_number": "803-296-7305",
            "fax_number": "803-296-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1316 N LAKE DR",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290727653",
            "telephone_number": "803-358-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PALMETTO HEALTH",
        "enumeration_date": "2011-10-17",
        "last_updated": "2015-08-17",
        "status": "A",
        "authorized_official_last_name": "COVEN",
        "authorized_official_first_name": "DARRELL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DIRECTOR, AMBULATORY SERVICESFINANC",
        "authorized_official_telephone_number": "803-296-7301",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP5806",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeview Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Palmetto Chiropractic Center Inc
• Palmetto Comprehensive Dentistry LLC
• Palmetto Dental Associates PA
• Palmetto Early Interventions, LLC
• Palmetto Endodontics, LLC
• Palmetto Health
• Palmetto Health
• Palmetto Health
• Palmetto Health
• Palmetto Health

• Family Medicine Physician in Lexington, SC
• Providers in Lexington, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2015; 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.