Organization Active NPI

Palmetto Endocrine Associates, Inc.

  • Endocrinology, Diabetes & Metabolism Physician
  • Orangeburg, SC
National Provider Identifier
1508809906
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
PALMETTO ENDOCRINE ASSOCIATES, INC.
Practice address
1709 Village Park Dr
Orangeburg, SC 29118-2401
Phone
(803) 515-9744
Fax
(803) 515-9733
NPI assigned
Jun 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Jocelyn A Myers, MD
Title
Managing Physician
Phone
(803) 515-9744

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X Primary

Addresses

Primary practice location

1709 Village Park Dr
Orangeburg, SC 29118-2401

Mailing address

1709 Village Park Dr
Orangeburg, SC 29118-2401
Phone (803) 515-9744

Other identifiers 1

IdentifierTypeStateIssuer
GP4264MedicaidSC

Other names 1

  • Palmetto Endocrine Associates, Inc. Other name

National Provider Directory

National Provider Directory

Locations

1709 Village Park Dr
Orangeburg, SC 29118
Phone (803) 515-9744

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1508809906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1709 VILLAGE PARK DR",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291182401",
            "telephone_number": "803-515-9744",
            "fax_number": "803-515-9733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 VILLAGE PARK DR",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291182401",
            "telephone_number": "803-515-9744",
            "fax_number": "803-515-9733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO ENDOCRINE ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "JOCELYN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGING PHYSICIAN",
        "authorized_official_telephone_number": "803-515-9744",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4264",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palmetto Endocrine Associates, Inc.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Orangeburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.