Active NPI
Roper Saint Francis Physicians Network
Doing business as Palmetto Podiatry
- Foot Surgery Podiatrist
- Mount Pleasant, SC
National Provider Identifier
1275857369
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot Surgery Podiatrist
- License
- 131
- Legal business name
- ROPER SAINT FRANCIS PHYSICIANS NETWORK
- Doing business as
- Palmetto Podiatry
- Practice address
- 3510 Highway 17 N
Suite 110
Mt Pleasant, SC 29466-8227 - Phone
- (843) 884-9159
- Fax
- (843) 971-1105
- NPI assigned
- Mar 18, 2010
- Last updated
- Oct 15, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Douglas Bowling
- Title
- VP Rsfpn
- Phone
- (843) 724-2903
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot Surgery Podiatrist | 213ES0131X | 131 | SC | Primary |
Addresses
Primary practice location
3510 Highway 17 N
Suite 110
Mt Pleasant, SC 29466-8227
Mailing address
PO Box 751649
Charlotte, NC 28275-1649
Phone (843) 789-1651
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DP0704 | Other | SC | RAILROAD MEDICARE GROUP PTAN |
| GP9893 | Medicaid | SC |
Other names 1
- Palmetto Podiatry
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090528000405 | SC | Part B Supplier - Clinic/Group Practice | 5193874824 |
Receives reassigned benefits from 837 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1268870400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1287100800000",
"number": "1275857369",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 751649",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282751649",
"telephone_number": "843-789-1651",
"fax_number": "843-724-2653"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3510 HIGHWAY 17 N",
"address_2": "SUITE 110",
"city": "MT PLEASANT",
"state": "SC",
"postal_code": "294668227",
"telephone_number": "843-884-9159",
"fax_number": "843-971-1105"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ROPER SAINT FRANCIS PHYSICIANS NETWORK",
"organizational_subpart": "NO",
"enumeration_date": "2010-03-18",
"last_updated": "2010-10-15",
"status": "A",
"authorized_official_last_name": "BOWLING",
"authorized_official_first_name": "DOUGLAS",
"authorized_official_title_or_position": "VP RSFPN",
"authorized_official_telephone_number": "843-724-2903",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "213ES0131X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot Surgery",
"state": "SC",
"license": "131",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE GROUP PTAN",
"identifier": "DP0704",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GP9893",
"state": "SC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Palmetto Podiatry",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Mount Pleasant, SC
- Roper Saint Francis Physicians Network
- Roper Saint Francis Physicians Network (Roper St. Francis Physician Partners)
- Roper Saint Francis Physicians Network (Roper St. Francis Physician Partners Primary Care)
- Roper Saint Francis Physicians Network (Roper St Francis Physician Partners Plastic and Reconstructive Surgery)
- Roper Saint Francis Physicians Network (Roper St. Francis Physician Partners Behavioral Medicine)
- Roper Saint Francis Physicians Network (Roper St. Francis Physician Partners Orthopaedics)
- Roper Saint Francis Physicians Network (Roper St. Francis Physician Partners Endocrinology)
- Roper Saint Francis Physicians Network (Roper St. Francis Physician Partners OB/GYN)
- Roper Saint Francis Physicians Network (Roper St. Francis Physician Partners OB/GYN)
- Roper Saint Francis Physicians Network (Roper St. Francis Physician Partners Behavioral Medicine)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; 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.