Palmetto Primary Care Physicians, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

10991 Issued in SC

Legal business name

PALMETTO PRIMARY CARE PHYSICIANS, LLC

Practice address

776 Daniel Ellis Dr
Ste. 1B
Charleston, SC 29412-3094

Phone

(843) 795-0300

Fax

(843) 795-1952

NPI assigned

Apr 22, 2009

Organization subpart

No

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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 4

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

• Kimberly A. Bova, DNP

  • Family Nurse Practitioner
  • Summerville, SC
  • NPI 1841605078
  NPD
• Rachel Davis, AGNP-C

  • Gerontology Nurse Practitioner
  • Charleston, SC
  • NPI 1285431304
  NPD
• Elizabeth Ashley Halicki, NP

  • Gerontology Nurse Practitioner
  • Charleston, SC
  • NPI 1770129553
  NPD
• Toni Danielle Kropilak, FNP

  • Primary Care Nurse Practitioner
  • North Charleston, SC
  • NPI 1598327975
  NPD

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

{
    "created_epoch": "1240358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622505600000",
    "number": "1649414632",
    "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": "776 DANIEL ELLIS DR",
            "address_2": "STE. 1B",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294123094",
            "telephone_number": "843-795-0300",
            "fax_number": "843-795-1952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO PRIMARY CARE PHYSICIANS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-22",
        "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": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "10991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP5175",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Palmetto Primary Care Physicians, LLC
• Palmetto Primary Care Physicians, LLC (PPCP Canterbury House)
• Palmetto Primary Care Physicians, LLC (Palmetto Vein Specialist)
• Palmetto Primary Care Physicians, LLC
• Palmetto Primary Care Physicians, LLC
• Palmetto Primary Care Physicians, LLC
• Palmetto Primary Care Physicians, LLC
• Palmetto Psych Services LLC (Inpatient Psychology Solutions)
• Palmetto Pulmonary Physicians of Charleston PA
• Palmetto Rainbow Dental Group LLC

• Family Medicine Physician in Charleston, SC
• Providers in Charleston, SC by specialty
• Family Medicine Physician in South Carolina

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.