NPIMap

Organization Active NPI

Palmetto Speech & Language Assoc, LLC

  • Speech-Language Pathologist
  • North Charleston, SC
National Provider Identifier
1184870206
Registry record updated Aug 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3120 Issued in SC
Legal business name
PALMETTO SPEECH & LANGUAGE ASSOC, LLC
Practice address
3185 Azalea Drive
North Charleston, SC 29405
Phone
(843) 388-9990
Fax
(843) 388-0349
NPI assigned
Aug 8, 2008
Last updated
Aug 8, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2008

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

Authorized official

Name
Ms. Gena C Randolph, MA, CCC-SLPNPI 1487696548
Title
Owner
Phone
(843) 388-9990

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 235Z00000X 3120 SC Primary

Addresses

Primary practice location

3185 Azalea Drive
North Charleston, SC 29405

Mailing address

1150 Hungryneck Blvd
Suite C-364
Mount Pleasant, SC 29464
Phone (843) 388-9990

National Provider Directory

National Provider Directory

Locations

1150 Hungryneck Blvd
#C364
Mount Pleasant, SC 29464
Phone (843) 388-9990

1417 Stuart Engals Blvd
Unit 201A
Mount Pleasant, SC 29464
Phone (843) 388-9990

1150 Hungryneck Blvd
Ste C
Mt Pleasant, SC 29464
Phone (843) 388-9990

1150 Hungryneck Blvd
Ste C364
Mt Pleasant, SC 29464
Phone (843) 388-9900

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1218153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218153600000",
    "number": "1184870206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 HUNGRYNECK BLVD",
            "address_2": "SUITE C-364",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "29464",
            "telephone_number": "843-388-9990",
            "fax_number": "843-388-0349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3185 AZALEA DRIVE",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "29405",
            "telephone_number": "843-388-9990",
            "fax_number": "843-388-0349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO SPEECH & LANGUAGE ASSOC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-08",
        "last_updated": "2008-08-08",
        "status": "A",
        "authorized_official_last_name": "RANDOLPH",
        "authorized_official_first_name": "GENA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-388-9990",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MA, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "3120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2008; 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.