Palmetto Primary Care Physicians, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PALMETTO PRIMARY CARE PHYSICIANS, LLC

Practice address

5500 Front St Ste 203
Summerville, SC 29486-8137

Phone

(843) 879-4060

Fax

(854) 220-0120

NPI assigned

Oct 30, 2019

Organization subpart

No

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

Authorized official

Name

Terry Cunningham, CEO

Title

Director

Phone

(843) 695-6071

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Palmetto Advanced Therapy Services Doing business as

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Tax ID family

Palmetto Primary Care P35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

Organizations that report the same tax identification number in the National Provider Directory.

• Palmetto Primary Care Physicians

  • Internal Medicine Physician
  • Irmo, SC
  • NPI 1568925071
  NPD tax ID
• Palmetto Primary Care Physicians, LLC

  • Family Medicine Physician
  • Charleston, SC
  • NPI 1003114406
  NPD tax ID
• Palmetto Primary Care Physicians, LLC

  • Physical Therapy Clinic/Center
  • Murrells Inlet, SC
  • NPI 1043808132
  NPD tax ID
• Palmetto Primary Care Physicians, LLC

  • Family Medicine Physician
  • Orangeburg, SC
  • NPI 1053020669
  NPD tax ID
• Palmetto Primary Care Physicians, LLC

  • Family Medicine Physician
  • Charleston, SC
  • NPI 1073234928
  NPD tax ID
• Palmetto Primary Care Physicians, LLC

  • Family Medicine Physician
  • Murrells Inlet, SC
  • NPI 1184190530
  NPD tax ID
• Palmetto Primary Care Physicians, LLC

  • Family Medicine Physician
  • Summerville, SC
  • NPI 1194281873
  NPD tax ID
• Palmetto Primary Care Physicians, LLC

  • Family Medicine Physician
  • Columbia, SC
  • NPI 1275177420
  NPD tax ID
• Palmetto Primary Care Physicians, LLC

  • Family Medicine Physician
  • N Charleston, SC
  • NPI 1275943953
  NPD tax ID
• Palmetto Primary Care Physicians, LLC

  • Family Medicine Physician
  • Pawleys Island, SC
  • NPI 1316410616
  NPD tax ID
• Palmetto Primary Care Physicians, LLC

  • Internal Medicine Physician
  • Columbia, SC
  • NPI 1326501834
  NPD tax ID
• Palmetto Primary Care Physicians, LLC

  • Family Medicine Physician
  • Summerville, SC
  • NPI 1366123739
  NPD tax ID

Locations

Practitioners 1

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

• Sasa Martinovic, PT

  • Physical Therapist
  • North Charleston, SC
  • NPI 1619297926
  NPD

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

{
    "created_epoch": "1572393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665446400000",
    "number": "1306480702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 530062",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303530062",
            "telephone_number": "843-695-6071",
            "fax_number": "843-569-5881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 FRONT ST STE 203",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294868137",
            "telephone_number": "843-879-4060",
            "fax_number": "854-220-0120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO PRIMARY CARE PHYSICIANS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-30",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A",
        "authorized_official_last_name": "CUNNINGHAM",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "843-695-6071",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PG1153",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palmetto Advanced Therapy Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Palmetto Primary Care Physicians, LLC
• Palmetto Primary Care Physicians, LLC
• Palmetto Primary Care Physicians, LLC
• Palmetto Primary Care Physicians, LLC
• Palmetto Primary Care Physicians, LLC
• Palmetto Primary Care Physicians, LLC
• Palmetto Primary Care Physicians, LLC
• Palmetto Primary Care Physicians, LLC
• Palmetto Primary Care Physicians, LLC
• Palmetto Primary Care Physicians, LLC

• All providers in Summerville, SC
• Physical Therapy Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2022; 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.