Individual provider Active NPI

Holland Anne Palmgren, NP

  • Nurse Practitioner
  • N Charleston, SC
National Provider Identifier
1306431580
Registry record updated Feb 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
24204 Issued in SC
Practice address
2810 Ashley Phosphate Rd Ste B4
N Charleston, SC 29418-6406
Phone
(843) 553-7744
Fax
(843) 553-7734
NPI assigned
Mar 9, 2021
Last updated
Feb 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 24204 SC Primary

Addresses

Primary practice location

2810 Ashley Phosphate Rd Ste B4
N Charleston, SC 29418-6406

Mailing address

2295 Henry Tecklenburg Dr
Charleston, SC 29414-7801
Phone (843) 766-7103

Other practice location 1

2295 Henry Tecklenburg Dr
Charleston, SC 29414-7801
Phone (843) 766-7103

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210421001025 SC Practitioner - Nurse Practitioner 4880002310 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Arias LLC CurrentSince Feb 12, 2023 Accepting new patients
Charleston ENT Associates, LLC CurrentSince Apr 1, 2021 Accepting new patients
Charleston ENT Associates, LLC CurrentSince Apr 1, 2021 Accepting new patients
Consultorio Medico Latino CurrentSince Feb 12, 2023 Accepting new patients

Locations

1849 Savage Rd
Charleston, SC 29407
Phone (843) 576-2600

2295 Henry Tecklenburg Dr
Charleston, SC 29414

5000 Epson Plantation Dr
Moncks Corner, SC 29461
Phone (843) 761-2000

2810 Ashley Phosphate Rd
Ste B4
North Charleston, SC 29418
Phone (843) 553-7744

Interoperability endpoints

  • Direct secure messaging: holland.palmgren.p1@direct.entap.nextgenshare.com

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1615248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676073600000",
    "number": "1306431580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2295 HENRY TECKLENBURG DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294147801",
            "telephone_number": "843-766-7103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 ASHLEY PHOSPHATE RD STE B4",
            "city": "N CHARLESTON",
            "state": "SC",
            "postal_code": "294186406",
            "telephone_number": "843-553-7744",
            "fax_number": "843-553-7734"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2295 Henry Tecklenburg Dr",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294147801",
            "country_code": "US",
            "telephone_number": "843-766-7103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALMGREN",
        "first_name": "HOLLAND",
        "middle_name": "ANNE",
        "name_prefix": "Miss",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-09",
        "last_updated": "2023-02-11",
        "certification_date": "2023-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "24204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in N Charleston, SC

Sources for this page

Verify at the official NPI Registry.