NPIMap

Organization Active NPI

Palmetto Pain Management, LLC

  • Non-Pharmacy Dispensing Site
  • Columbia, SC
National Provider Identifier
1629457650
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
13894 Issued in SC
Legal business name
PALMETTO PAIN MANAGEMENT, LLC
Practice address
2611 Forest Dr Ste 200
Columbia, SC 29204-2371
Phone
(803) 779-3263
Fax
(803) 779-3207
NPI assigned
May 22, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

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

Authorized official

Name
Jennifer Hodge
Title
Practice Administrator
Phone
(803) 779-3263

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X 13894 SC Primary

Addresses

Primary practice location

2611 Forest Dr Ste 200
Columbia, SC 29204-2371

Mailing address

2611 Forest Dr Ste 200
Columbia, SC 29204-2371
Phone (803) 779-3263

National Provider Directory

National Provider Directory

Locations

2611 Forest Dr
Ste 200
Columbia, SC 29204
Phone (803) 779-3263

Practitioners & affiliated clinicians

Practitioners 8

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": "1432252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639353600000",
    "number": "1629457650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2611 FOREST DR STE 200",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042371",
            "telephone_number": "803-779-3263",
            "fax_number": "803-779-3207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2611 FOREST DR STE 200",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042371",
            "telephone_number": "803-779-3263",
            "fax_number": "803-779-3207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO PAIN MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-22",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A",
        "authorized_official_last_name": "HODGE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "803-779-3263"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "SC",
            "license": "13894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2021; 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.