Palmetto PA Assist, LLC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Legal business name

PALMETTO PA ASSIST, LLC

Practice address

2880 Tricom St
North Charleston, SC 29406-9171

Phone

(843) 353-1163

NPI assigned

Apr 12, 2019

Organization subpart

No

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

Authorized official

Name

Roxanna Leroque

Title

Director of Client Experience

Phone

(210) 598-2801

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1555027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654819200000",
    "number": "1154884468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 N LOOP 1604 E #105-612",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78232",
            "telephone_number": "843-353-1163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2880 TRICOM ST",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069171",
            "telephone_number": "843-353-1163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO PA ASSIST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-12",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A",
        "authorized_official_last_name": "LEROQUE",
        "authorized_official_first_name": "ROXANNA",
        "authorized_official_title_or_position": "DIRECTOR OF CLIENT EXPERIENCE",
        "authorized_official_telephone_number": "210-598-2801"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in North Charleston, SC
• Providers in North Charleston, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; 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.