Palmetto Health

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PALMETTO HEALTH

Practice address

100 Palmetto Health Pkwy
Suite 250B
Columbia, SC 29212-1753

Phone

(803) 407-3734

Fax

(803) 407-3133

NPI assigned

Mar 6, 2013

Organization subpart

No

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

Authorized official

Name

Darrell Coven

Title

Director, Ambulatory Services-Fin

Phone

(803) 296-7301

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Parkridge OB/GYN Doing business as

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

{
    "created_epoch": "1362528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466726400000",
    "number": "1649511320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 402145",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303842145",
            "telephone_number": "803-296-7305",
            "fax_number": "803-296-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PALMETTO HEALTH PKWY",
            "address_2": "SUITE 250B",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292121753",
            "telephone_number": "803-407-3734",
            "fax_number": "803-407-3133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-06",
        "last_updated": "2016-06-24",
        "status": "A",
        "authorized_official_last_name": "COVEN",
        "authorized_official_first_name": "DARRELL",
        "authorized_official_title_or_position": "DIRECTOR, AMBULATORY SERVICES-FIN",
        "authorized_official_telephone_number": "803-296-7301"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP6159",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Parkridge OB/GYN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Palmetto Health
• Palmetto Health
• Palmetto Health
• Palmetto Health
• Palmetto Health
• Palmetto Health
• Palmetto Health
• Palmetto Health
• Palmetto Health
• Palmetto Health

• Family Medicine Physician in Columbia, SC
• Providers in Columbia, 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 24, 2016; 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.