Active NPI
Palmetto Health
Doing business as Midlands Internal Medicine
- Internal Medicine Physician
- Columbia, SC
National Provider Identifier
1174544886
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- PALMETTO HEALTH
- Doing business as
- Midlands Internal Medicine
- Practice address
- 3000 NE Medical Park
Suite 108
Columbia, SC 29223-6251 - Phone
- (803) 462-9200
- Fax
- (803) 699-1474
- NPI assigned
- Jul 21, 2006
- Last updated
- Jan 22, 2010
- Organization subpart
- Yes
- Parent organization
- PALMETTO HEALTH ALLIANCE
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Darrell C Coven
- Title
- Director, Ambulatory SVCS - Finance
- Phone
- (803) 296-7301
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | NU | Primary |
Addresses
Primary practice location
3000 NE Medical Park
Suite 108
Columbia, SC 29223-6251
Mailing address
PO Box 402145
Atlanta, GA 30384-2145
Phone (803) 296-7305
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GP2081 | Medicaid | SC | |
| CG5471 | Other | SC | MEDICARE RAILROAD GROUP PTAN |
Other names 1
- Midlands Internal Medicine
National Provider Directory
National Provider Directory- Part of
- Northeast Family Practi
Locations
3000 NE Medical Park
Ste 108
Columbia, SC 29223
Phone (803) 462-9200
Practitioners & affiliated clinicians
Practitioners 5
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.
-
- Internal Medicine Physician
- Columbia, SC
- NPI 1316907157
-
- Internal Medicine Physician
- Columbia, SC
- NPI 1265409189
-
- Internal Medicine Physician
- Columbia, SC
- NPI 1881687440
-
- Specialist
- Miami, OK
- NPI 1366444648
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153440000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1264118400000",
"number": "1174544886",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 402145",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303842145",
"telephone_number": "803-296-7305",
"fax_number": "803-296-7330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 NE MEDICAL PARK",
"address_2": "SUITE 108",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292236251",
"telephone_number": "803-462-9200",
"fax_number": "803-699-1474"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PALMETTO HEALTH",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PALMETTO HEALTH ALLIANCE",
"enumeration_date": "2006-07-21",
"last_updated": "2010-01-22",
"status": "A",
"authorized_official_last_name": "COVEN",
"authorized_official_first_name": "DARRELL",
"authorized_official_middle_name": "C",
"authorized_official_title_or_position": "DIRECTOR, AMBULATORY SVCS - FINANCE",
"authorized_official_telephone_number": "803-296-7301"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GP2081",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD GROUP PTAN",
"identifier": "CG5471",
"state": "SC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Midlands Internal Medicine",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Columbia, SC
- Palmetto Health (Palmetto OB/GYN Associates)
- Palmetto Health (Hospitalists in Psychiatry)
- Palmetto Health (Three Rivers Medical Associates)
- Palmetto Health (Columbia Women's Healthcare)
- Palmetto Health (Pediatric Palliative Care)
- Palmetto Health (Childrens Hospital Intensivists)
- Palmetto Health (South Hampton Family Practice)
- Palmetto Health (Palmetto Health Surgical Specialists)
- Palmetto Health (Irmo Family Practice)
- Palmetto Health (Premier Orthopedic Specialists)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.