Active NPI
Palmetto Internal Medicine & Primary Care, PA
- Internal Medicine Physician
- Mauldin, SC
National Provider Identifier
1124335898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 19652
- Legal business name
- PALMETTO INTERNAL MEDICINE & PRIMARY CARE, PA
- Practice address
- 300 W Butler Rd
Mauldin, SC 29662-2538 - Phone
- (864) 277-8300
- Fax
- (864) 288-8722
- NPI assigned
- Sep 1, 2010
- 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
- Bala Krishniah, MD
- Title
- Physician Owner
- Phone
- (864) 991-9015
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 19652 | SC | Primary |
Addresses
Primary practice location
300 W Butler Rd
Mauldin, SC 29662-2538
Mailing address
300 W Butler Rd
Mauldin, SC 29662-2538
Phone (864) 277-8300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 42D2013664 | Palmetto Internal Medicine & Primary Care PA | Provider-performed microscopy | Sep 22, 2026 |
National Provider Directory
National Provider DirectoryLocations
545 W Butler Rd
#A
Greenville, SC 29607
Phone (864) 236-9555
511 W Butler Rd
#A
Greenville, SC 29607
Phone (864) 277-8300
300 W Butler Rd
Mauldin, SC 29662
Phone (864) 277-8300
Practitioners & affiliated clinicians
Practitioners 13
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Physician Assistant
- Mauldin, SC
- NPI 1023873650
-
- Family Nurse Practitioner
- Mauldin, SC
- NPI 1861031031
-
- Internal Medicine Physician
- Mauldin, SC
- NPI 1891724951
-
- Family Nurse Practitioner
- Mauldin, SC
- NPI 1508621657
-
- Family Nurse Practitioner
- Mauldin, SC
- NPI 1164282117
-
- Family Nurse Practitioner
- Mauldin, SC
- NPI 1730605254
-
- Nurse Practitioner
- Columbia, SC
- NPI 1215619796
-
- Family Nurse Practitioner
- Greenville, SC
- NPI 1841821162
-
- Family Nurse Practitioner
- Greenville, SC
- NPI 1104368174
-
- Family Nurse Practitioner
- Greenville, SC
- NPI 1437741394
-
- Family Nurse Practitioner
- West Columbia, SC
- NPI 1891164216
-
- Family Nurse Practitioner
- Greenville, SC
- NPI 1568929156
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283299200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1352764800000",
"number": "1124335898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 W BUTLER RD",
"city": "MAULDIN",
"state": "SC",
"postal_code": "296622538",
"telephone_number": "864-277-8300",
"fax_number": "864-288-8722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 W BUTLER RD",
"city": "MAULDIN",
"state": "SC",
"postal_code": "296622538",
"telephone_number": "864-277-8300",
"fax_number": "864-288-8722"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PALMETTO INTERNAL MEDICINE & PRIMARY CARE, PA",
"organizational_subpart": "NO",
"enumeration_date": "2010-09-01",
"last_updated": "2012-11-13",
"status": "A",
"authorized_official_last_name": "KRISHNIAH",
"authorized_official_first_name": "BALA",
"authorized_official_title_or_position": "PHYSICIAN OWNER",
"authorized_official_telephone_number": "864-991-9015",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "SC",
"license": "19652",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mauldin, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.