Palmetto Adult and Childrens Urology PA

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

Legal business name

PALMETTO ADULT AND CHILDRENS UROLOGY PA

Practice address

2890 Tricom St
North Charleston, SC 29406-9171

Phone

(843) 797-6600

Fax

(843) 820-1440

NPI assigned

Sep 28, 2023

Organization subpart

No

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

Authorized official

Name

Amelia Munkberg

Title

Practice Administrator

Phone

(843) 797-6600

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Taylor B Vaughan, MD

  • Urology Physician
  • North Charleston, SC
  • NPI 1467770131
  NPD

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

{
    "created_epoch": "1695859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695859200000",
    "number": "1336928282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2890 TRICOM ST",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069171",
            "telephone_number": "843-797-6600",
            "fax_number": "843-820-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2890 TRICOM ST",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069171",
            "telephone_number": "843-797-6600",
            "fax_number": "843-820-1440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO ADULT AND CHILDRENS UROLOGY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-28",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A",
        "authorized_official_last_name": "MUNKBERG",
        "authorized_official_first_name": "AMELIA",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "843-797-6600"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pain Specialists of Charleston
• Pain Specialists of Charleston
• Pain Specialists of Charleston PA
• David Palmer
• John Ross Palmer Sr., LPC
• Palmetto Adult and Childrens Urology PA
• Palmetto Angels
• Palmetto Family Care
• Palmetto Family Homecare, LLC
• Palmetto Goodwill

• Non-Pharmacy Dispensing Site in North Charleston, SC
• Providers in North Charleston, SC by specialty
• Non-Pharmacy Dispensing Site in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; 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.