Palmetto Urological PA

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

PALMETTO UROLOGICAL PA

Practice address

11 Park Creek Dr
Greenville, SC 29605-4270

Phone

(864) 242-1220

NPI assigned

Jun 19, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Jennifer L Mitchell

Title

Office Manager

Phone

(864) 244-1220

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184669376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 PARK CREEK DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054270",
            "telephone_number": "864-242-1220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 PARK CREEK DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054270",
            "telephone_number": "864-242-1220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO UROLOGICAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "864-244-1220",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA0784-PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Palmetto Periodontics PA
• Palmetto Physical Medicine
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• Palmetto Sports and Family Chiropractic
• Palmetto Supportive Services
• Palms Dentistry 226 LLC
• Jennifer Palomo
• Kristen E. Pandke, M.D.
• Sarah Panebianco
• Jonathan Trent Pannell, MD

• Specialist in Greenville, SC
• Providers in Greenville, SC by specialty
• Specialist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.