Palmetto Brace Shop Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

PALMETTO BRACE SHOP INC

Practice address

1910 Hampton Street
Columbia, SC 29201

Phone

(803) 254-1632

Fax

(803) 254-0922

NPI assigned

Mar 7, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Charles N Derrick

Title

Owner President

Phone

(803) 254-1632

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497722565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 HAMPTON STREET",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29201",
            "telephone_number": "803-254-1632",
            "fax_number": "803-254-0922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 HAMPTON STREET",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29201",
            "telephone_number": "803-254-1632",
            "fax_number": "803-254-0922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO BRACE SHOP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DERRICK",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "803-254-1632",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "540515",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Palmetto Anesthesiology Consultants, LLC
• Palmetto Anesthesiology Medicine
• Palmetto Autism Interventions, LLC
• Palmetto Biotech Prosthetics & Orthotics LLC
• Palmetto Birth
• Palmetto Cardiology Associates, PA
• Palmetto Care Bears Home Health Care, LLC
• Palmetto Community Group, LLC
• Palmetto Comprehensive Behavioral Health
• Palmetto Dental Services

• Prosthetic/Orthotic Supplier in Columbia, SC
• Providers in Columbia, SC by specialty
• Prosthetic/Orthotic Supplier in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.