Palmetto Pediatrics

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PALMETTO PEDIATRICS

Practice address

2450 India Hook Rd
Suite a
Rock Hill, SC 29732-3270

Phone

(803) 327-5772

Fax

(803) 327-9303

NPI assigned

Jul 5, 2006

Last updated

Apr 25, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Daniel L. Wiens

Title

Senior Vice President

Phone

(704) 355-0648

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Palmetto Pediatrics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Palmetto Pediatrics

  • Pediatrics Physician
  • Charlotte, NC
  • NPI 1528397593
  NPD tax ID

Locations

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366848000000",
    "number": "1508897109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60099",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600099",
            "telephone_number": "803-327-5772",
            "fax_number": "803-327-9303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 INDIA HOOK RD",
            "address_2": "SUITE A",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297323270",
            "telephone_number": "803-327-5772",
            "fax_number": "803-327-9303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2013-04-25",
        "status": "A",
        "authorized_official_last_name": "WIENS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "704-355-0648"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5906681",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP0671",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Palmetto Dental PA
• Palmetto Eyecare Associates P a
• Palmetto Family Pharmacy
• Palmetto Meals
• Palmetto Oxygen, LLC
• Palmetto Pharmacy Online Inc (Palmetto Pharmacy Online)
• Palmetto Physical Medicine
• Palmetto Podiatry Group of Anderson, PA
• Palmetto Podiatry Group of Anderson, PA
• Palmetto Rehabilitation Specialists

• Pediatrics Physician in Rock Hill, SC
• Providers in Rock Hill, SC by specialty
• Pediatrics Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2013; 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.