NPIMap

Organization Active NPI

Palmetto Podiatry Group of Anderson, PA

  • Podiatrist
  • Fort Mill, SC
National Provider Identifier
1477723724
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
PALMETTO PODIATRY GROUP OF ANDERSON, PA
Practice address
105 Ben Casey Dr
Suite 133
Fort Mill, SC 29708-8561
Phone
(803) 396-8670
Fax
(803) 396-8657
NPI assigned
Mar 3, 2008
Last updated
Feb 26, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Authorized official

Name
James Leon Rose, DPMNPI 1891891644
Title
DPM/Owner
Phone
(864) 231-6395

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
Durable Medical Equipment & Medical Supplies 332B00000X NU
Podiatrist 213E00000X NU Primary
Foot & Ankle Surgery Podiatrist 213ES0103X NU

Addresses

Primary practice location

105 Ben Casey Dr
Suite 133
Fort Mill, SC 29708-8561

Mailing address

PO Box 825159
Philadelphia, PA 19182-5159
Phone (803) 396-8670

Other identifiers 1

IdentifierTypeStateIssuer
GP9957MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240315001465 SC DME Supplier - Physician - Podiatry 4981741360 Practice locations: Fort Mill, SC

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Palmetto Podiatry Group of Anderson PA6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

1103 N Fant St
Anderson, SC 29621
Phone (864) 231-6395

2126 Highway 81 N
Anderson, SC 29621
Phone (864) 226-2660

2126 Highway 81 N
#B
Anderson, SC 29621
Phone (864) 231-6395

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740528000000",
    "number": "1477723724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 825159",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191825159",
            "telephone_number": "803-396-8670",
            "fax_number": "803-396-8657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 BEN CASEY DR",
            "address_2": "SUITE 133",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297088561",
            "telephone_number": "803-396-8670",
            "fax_number": "803-396-8657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO PODIATRY GROUP OF ANDERSON, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-03",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A",
        "authorized_official_last_name": "ROSE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "LEON",
        "authorized_official_title_or_position": "DPM/OWNER",
        "authorized_official_telephone_number": "864-231-6395",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP9957",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Mill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2025; 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.