Palmetto Pain Center PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

33094 Issued in SC

Legal business name

PALMETTO PAIN CENTER PA

Practice address

41 Marshellen Dr
Suite a
Beaufort, SC 29902-6900

Phone

(843) 522-3456

Fax

(843) 522-8263

NPI assigned

Oct 26, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Karen M Eller, M.D.NPI 1205888765

Title

Director/Owner

Phone

(843) 522-3456

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in SC2 enrollments

Enrollment records 2

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HEFAAA

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Karen Eller, M.D.

  • Specialist
  • Beaufort, SC
  • NPI 1205888765
  Medicare reassignment Care Compare group NPD Authorized official
• Tiffany Rahn, PA-C

  • Physician Assistant
  • Beaufort, SC
  • NPI 1790004356
  Medicare reassignment Care Compare group
• William Daniel White, MD

  • Physical Medicine & Rehabilitation Physician
  • Spartanburg, SC
  • NPI 1982100483
  Medicare reassignment NPD

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590019200000",
    "number": "1275618332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 MARSHELLEN DR",
            "address_2": "SUITE A",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299026900",
            "telephone_number": "843-522-3456",
            "fax_number": "843-522-8263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 MARSHELLEN DR",
            "address_2": "SUITE A",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299026900",
            "telephone_number": "843-522-3456",
            "fax_number": "843-522-8263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO PAIN CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2020-05-21",
        "status": "A",
        "authorized_official_last_name": "ELLER",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "843-522-3456",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "SC",
            "license": "33094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1205888765",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECIALTY NUMBER",
            "identifier": "33094",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL SECURITY NUMBER",
            "identifier": "$$$$$$$$$",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP0036",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "21483",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justin Palmer
• Palmetto Care Transport LLC
• Palmetto Center of Psychiatry (Palmetto Specialty LTC)
• Palmetto Counseling Collective, LLC
• Palmetto Nutrition Consulting, LLC
• Palmetto Pulmonary Medicine. P.a.
• Palmetto Smiles of Beaufort LLC
• Karin Palo, RN
• Ashlee Panzer, SLP
• Jacob Paris, MS

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.