NPIMap

Organization Active NPI

Palmetto Primary Care Physicians, LLC

  • Family Medicine Physician
  • N Charleston, SC
National Provider Identifier
1629017694
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PALMETTO PRIMARY CARE PHYSICIANS, LLC
Practice address
2550 Elms Center Rd
N Charleston, SC 29406-9844
Phone
(843) 572-7727
Fax
(843) 569-5872
NPI assigned
Jun 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2021

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

Authorized official

Name
Dr. Thomas Brantley Arnau, MD
Title
President
Phone
(843) 572-7727

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X
Diagnostic Ultrasound PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085U0001X
Magnetic Resonance Imaging (MRI) Clinic/Center 261QM1200X
Physical Therapy Clinic/Center 261QP2000X
Urgent Care Clinic/Center 261QU0200X
Clinical Medical Laboratory 291U00000X

Addresses

Primary practice location

2550 Elms Center Rd
N Charleston, SC 29406-9844

Mailing address

PO Box 530062
Atlanta, GA 30353-0062
Phone (843) 695-6071

Other identifiers 3

IdentifierTypeStateIssuer
DPE087OtherSCMEDICAID DIABETES EDU
GP1551MedicaidSC
CD2393OtherSCRR MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031113000287 SC Part B Supplier - Clinic/Group Practice 4880508068 Receives reassigned benefits from 345 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Locations

119 Springhall Dr
#A2
Goose Creek, SC 29445
Phone (843) 266-2520

119 Springhall Dr
Goose Creek, SC 29445
Phone (843) 266-2520

115 Executive Pkwy
Moncks Corner, SC 29461
Phone (843) 761-2815

9313 Medical Plaza Dr
Ste 310
North Charleston, SC 29406
Phone (843) 569-1856

1205 Hutto St
Orangeburg, SC 29118
Phone (803) 531-3911

1101 Old Trolley Rd
Ste 300
Summerville, SC 29485
Phone (843) 376-2670

90 Springview Ln
#A
Summerville, SC 29485
Phone (843) 832-9113

5500 Front St
Ste 240
Summerville, SC 29486
Phone (854) 220-9995

3020 Sunset Blvd
Ste 101
West Columbia, SC 29169
Phone (803) 791-5680

Practitioners 43

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

View all 43

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D2040729Palmetto Primary Physicians -2550 Elms Center Road, North Charleston, SC 29406ComplianceApr 10, 2027

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622505600000",
    "number": "1629017694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 530062",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303530062",
            "telephone_number": "843-695-6071",
            "fax_number": "843-569-5881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 ELMS CENTER RD",
            "city": "N CHARLESTON",
            "state": "SC",
            "postal_code": "294069844",
            "telephone_number": "843-572-7727",
            "fax_number": "843-569-5872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO PRIMARY CARE PHYSICIANS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-05",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A",
        "authorized_official_last_name": "ARNAU",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "BRANTLEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-572-7727",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DIABETES EDU",
            "identifier": "DPE087",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP1551",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CD2393",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in N Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.