NPIMap

Individual provider Active NPI

Jennifer Ruth Palo, FNP

  • Family Nurse Practitioner
  • Summerville, SC
National Provider Identifier
1215048764
Registry record updated Apr 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2610 Issued in SC
Practice address
87 Springview Lane
Summerville, SC 29485
Phone
(843) 876-7979
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2610 SC Primary

Addresses

Primary practice location

87 Springview Lane
Summerville, SC 29485

Mailing address

PO Box 602108
Charlotte, NC 28260-2108
Phone (843) 792-6200

Other identifiers 2

IdentifierTypeStateIssuer
NP0905MedicaidSC
P00953705OtherSCRAIL ROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050811000407 SC Practitioner - Nurse Practitioner 2163451998 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolina Family Care IncGroup PAC ID 4587557731, 81 clinicians

Practice addresses (Care Compare)

1208 Two Island CT
Mt Pleasant, SC 29466-7436
Phone (843) 884-6653

Hospital & facility affiliations

  • Musc Medical Center Hospital, Charleston, SC, CCN 420004
  • Novant Health East Cooper Medical Center Hospital, Mount Pleasant, SC, CCN 420089
  • Mount Pleasant Hospital Hospital, Mount Pleasant, SC, CCN 420104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2610SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Palmetto Primary Care Physicians, LLC CurrentSince Oct 21, 2006 Accepting new patients
Carolina Family Care, Inc CurrentSince Apr 1, 2016 Accepting new patients
Carolina Family Care, Inc CurrentSince Aug 1, 2018 Accepting new patients
Palmetto Primary Care Physicians, LLC Current Accepting new patients
Carolina Family Care, Inc Past Accepting new patients

Locations

490 Martello Dr
Charleston, SC 29412
Phone (843) 762-4963

2125 Charlie Hall Blvd
Ste 2B
Charleston, SC 29414
Phone (843) 852-3151

1003 Landfall Way
Johns Island, SC 29455
Phone (843) 768-0888

1208 Two Island Ct
Mt Pleasant, SC 29466
Phone (843) 884-6653

1200 Innovation Way
Ste 101B
Mt Pleasant, SC 29466
Phone (843) 876-1445

1113 Park West Blvd
Mt Pleasant, SC 29466
Phone (843) 876-1445

1440 Ben Sawyer Blvd
Ste 1109
Mt Pleasant, SC 29464
Phone (843) 876-8333

2550 Elms Center Rd
North Charleston, SC 29406
Phone (843) 302-8840

8992 University Blvd
Ste 300
North Charleston, SC 29406
Phone (843) 876-8279

602 N Main St
Summerville, SC 29483
Phone (843) 876-2121

87 Springview Ln
Summerville, SC 29485
Phone (843) 876-7979

300 W 4th North St
Summerville, SC 29483
Phone (843) 285-7515

Interoperability endpoints

  • Direct secure messaging: jpalo190138@direct.musc.edu

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461110400000",
    "number": "1215048764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602108",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602108",
            "telephone_number": "843-792-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 SPRINGVIEW LANE",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "29485",
            "telephone_number": "843-876-7979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALO",
        "first_name": "JENNIFER",
        "middle_name": "RUTH",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2016-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "2610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP0905",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00953705",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

Verify at the official NPI Registry.