Palmetto Internal Medicine & Primary Care, PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

19652 Issued in SC

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

Last updated

Nov 13, 2012By the provider in NPPES

Organization subpart

No

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

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 13

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.

• Zachary Joseph Fuchs, PA

  • Physician Assistant
  • Mauldin, SC
  • NPI 1023873650
  Medicare reassignment Care Compare group NPD
• Nicole Marie Kizer, NP

  • Family Nurse Practitioner
  • Mauldin, SC
  • NPI 1861031031
  Medicare reassignment Care Compare group NPD
• Balasubramanyam Krishniah, M.D.

  • Internal Medicine Physician
  • Mauldin, SC
  • NPI 1891724951
  Medicare reassignment Care Compare group NPD
• Logan Hawkins McCuen

  • Family Nurse Practitioner
  • Mauldin, SC
  • NPI 1508621657
  Medicare reassignment Care Compare group NPD
• Erica Michelle Noone, FNP

  • Family Nurse Practitioner
  • Mauldin, SC
  • NPI 1164282117
  Medicare reassignment Care Compare group NPD
• Alicia M Ruhland, DNP

  • Family Nurse Practitioner
  • Mauldin, SC
  • NPI 1730605254
  Medicare reassignment Care Compare group NPD
• Shannon Nicole Diroma, APRN

  • Nurse Practitioner
  • Columbia, SC
  • NPI 1215619796
  Medicare reassignment NPD
• Jeremy Alex Fuller, NP

  • Family Nurse Practitioner
  • Greenville, SC
  • NPI 1841821162
  Medicare reassignment NPD
• Kathryn Lea Luckett, NP

  • Family Nurse Practitioner
  • Greenville, SC
  • NPI 1104368174
  Medicare reassignment NPD
• Asa Kykeemha McCluskey, FNP

  • Family Nurse Practitioner
  • Greenville, SC
  • NPI 1437741394
  Medicare reassignment NPD
• Lorena Middleton, FNP

  • Family Nurse Practitioner
  • West Columbia, SC
  • NPI 1891164216
  Medicare reassignment NPD
• Victoria Baker Stephens, NP

  • Family Nurse Practitioner
  • Greenville, SC
  • NPI 1568929156
  Medicare reassignment NPD

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": []
}

• Owlwise Therapy Studios LLC
• Pace Pediatric Therapies
• Anna Lee Quiamco Pahila
• Connie Painter
• Palmetto Disablility Evaluations, Inc. (Charles B Thomas JR., Md Orthopaedic Surgery)
• Joseph F Paradise, DMD
• Jihyun Park
• Kimberly Gaston Parker, NP
• Parks Family Dental
• Ashley Cerone Parks, M.D.

• Internal Medicine Physician in Mauldin, SC
• Providers in Mauldin, SC by specialty
• Internal Medicine Physician in South Carolina

• 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.

Verify at the official NPI Registry.