NPIMap

Organization Active NPI

Palmetto Health

  • Family Medicine Physician
  • Columbia, SC
National Provider Identifier
1194770958
Registry record updated Oct 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PALMETTO HEALTH
Doing business as
South Hampton Family Practice
Practice address
5900 Garners Ferry Rd
Columbia, SC 29209-1301
Phone
(803) 695-5450
Fax
(803) 695-5469
NPI assigned
May 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2008

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

Authorized official

Name
Darrell C Coven
Title
Director of Business Dev., Finance
Phone
(803) 233-1025

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

5900 Garners Ferry Rd
Columbia, SC 29209-1301

Mailing address

PO Box 402145
Atlanta, GA 30384-2145
Phone (803) 695-5450

Other identifiers 1

IdentifierTypeStateIssuer
GP2836MedicaidSC

Other names 1

  • South Hampton Family Practice Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223942400000",
    "number": "1194770958",
    "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": "803-695-5450",
            "fax_number": "803-695-5469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 GARNERS FERRY RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292091301",
            "telephone_number": "803-695-5450",
            "fax_number": "803-695-5469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2008-10-14",
        "status": "A",
        "authorized_official_last_name": "COVEN",
        "authorized_official_first_name": "DARRELL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS DEV., FINANCE",
        "authorized_official_telephone_number": "803-233-1025"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2836",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Hampton Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.