NPIMap

Organization Active NPI

Palmetto Health

  • Family Medicine Physician
  • Easley, SC
National Provider Identifier
1265645352
Registry record updated Nov 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PALMETTO HEALTH
Practice address
104 Fleetwood Drive
Easley, SC 29640
Phone
(864) 859-3998
Fax
(864) 855-1045
NPI assigned
May 7, 2007
Organization subpart
Yes
Parent organization
PALMETTO HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 18, 2008

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

Authorized official

Name
Kendall J Durham
Title
Financial Services Rep-Manager
Phone
(864) 855-5104

Specialties & licenses 1

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

Addresses

Primary practice location

104 Fleetwood Drive
Easley, SC 29640

Mailing address

PO Box 2089
Easley, SC 29641-2089
Phone (864) 855-5104

Other identifiers 1

IdentifierTypeStateIssuer
DE1917MedicaidSC

Other names 1

  • Medical Center of Easley Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Markowitz and Associates105 organizations share this tax ID, including this one
Part of
Markowitz and Associates

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226966400000",
    "number": "1265645352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2089",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296412089",
            "telephone_number": "864-855-5104",
            "fax_number": "864-859-9362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 FLEETWOOD DRIVE",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "29640",
            "telephone_number": "864-859-3998",
            "fax_number": "864-855-1045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PALMETTO HEALTH",
        "enumeration_date": "2007-05-07",
        "last_updated": "2008-11-18",
        "status": "A",
        "authorized_official_last_name": "DURHAM",
        "authorized_official_first_name": "KENDALL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "FINANCIAL SERVICES REP-MANAGER",
        "authorized_official_telephone_number": "864-855-5104"
    },
    "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": "DE1917",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Center of Easley",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Easley, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.