Palmetto Primary Care Physicians

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

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

Organization subpart

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CGJJCA

Practitioners 1

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

• Thomas Richard Bolt, MD

  • Family Medicine Physician
  • N Charleston, SC
  • NPI 1639136377
  NPD

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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3821",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• 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, LLC
• Kayla Param
• Amy M Parker, RN

• Family Medicine Physician in Moncks Corner, SC
• Providers in Moncks Corner, 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 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.