NPIMap

Organization Active NPI

Palmetto Psychiatry Consultants, LLC

  • Psychiatry Physician
  • Columbia, SC
National Provider Identifier
1275822249
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
PALMETTO PSYCHIATRY CONSULTANTS, LLC
Practice address
4500 Fort Jackson Blvd Ste 270
Columbia, SC 29209-1119
Phone
(803) 764-3555
Fax
(803) 764-4418
NPI assigned
Mar 30, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

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

Authorized official

Name
Dr. Jesse Raley, M.D.NPI 1851422422
Title
Owner
Phone
(803) 764-3555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Forensic Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084F0202X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X

Addresses

Primary practice location

4500 Fort Jackson Blvd Ste 270
Columbia, SC 29209-1119

Mailing address

4500 Fort Jackson Blvd Ste 270
Columbia, SC 29209-1119
Phone (803) 764-3555

National Provider Directory

National Provider Directory

Locations

4500 Fort Jackson Blvd
Ste 270
Columbia, SC 29209
Phone (803) 764-3555

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1301443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704326400000",
    "number": "1275822249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 FORT JACKSON BLVD STE 270",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292091119",
            "telephone_number": "803-764-3555",
            "fax_number": "803-764-4418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 FORT JACKSON BLVD STE 270",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292091119",
            "telephone_number": "803-764-3555",
            "fax_number": "803-764-4418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO PSYCHIATRY CONSULTANTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-30",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A",
        "authorized_official_last_name": "RALEY",
        "authorized_official_first_name": "JESSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-764-3555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084F0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jan 4, 2024; 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.