Active NPI
Palmetto Primary Care Physicians
- Family Medicine Physician
- Moncks Corner, SC
National Provider Identifier
1104866623
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- PALMETTO PRIMARY CARE PHYSICIANS
- Practice address
- 401 N Live Oak Dr
Ste. B
Moncks Corner, SC 29461-5603 - Phone
- (843) 761-7884
- Fax
- (843) 761-9047
- NPI assigned
- Jun 7, 2006
- Last updated
- Jun 1, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Thomas Brantley Arnau, MD
- Title
- President
- Phone
- (843) 572-7727
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | SC | Primary |
Addresses
Primary practice location
401 N Live Oak Dr
Ste. B
Moncks Corner, SC 29461-5603
Mailing address
PO Box 530062
Atlanta, GA 30353-0062
Phone (843) 695-6071
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031113000287 | SC | Part B Supplier - Clinic/Group Practice | 4880508068 |
Receives reassigned benefits from 345 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider DirectoryInteroperability endpoints
- https://fhir4.healow.com/fhir/r4/CGJJCA
Practitioners & affiliated clinicians
Practitioners 2
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.
-
- Family Medicine Physician
- Charleston, SC
- NPI 1477510022
-
- Family Medicine Physician
- N Charleston, SC
- NPI 1639136377
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1622505600000",
"number": "1104866623",
"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": "401 N LIVE OAK DR",
"address_2": "STE. B",
"city": "MONCKS CORNER",
"state": "SC",
"postal_code": "294615603",
"telephone_number": "843-761-7884",
"fax_number": "843-761-9047"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PALMETTO PRIMARY CARE PHYSICIANS",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-07",
"last_updated": "2021-06-01",
"certification_date": "2021-06-01",
"status": "A",
"authorized_official_last_name": "ARNAU",
"authorized_official_first_name": "THOMAS",
"authorized_official_middle_name": "BRANTLEY",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "843-572-7727",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "SC",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Moncks Corner, SC
- Ovp Health Care, Inc.
- Tyler Owen
- Johnette Owens
- Jeni Bowers Palmer, LPC
- Palmetto Emergency Physicians, LLC
- Palmetto Primary Care Physicians, LLC
- Palmetto Primary Care Physicians, LLC (Palmetto Primary Care Physicians Gastroenterology)
- Palmetto Primary Care Physicians, LLC
- Kayla Param
- Amy M Parker, RN
Sources for this page
- 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.