NPIMap

Organization Active NPI

Palmetto Health

  • Family Medicine Physician
  • Columbia, SC
National Provider Identifier
1659316743
Registry record updated Dec 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PALMETTO HEALTH
Practice address
3000 NE Medical Park
Suite 209
Columbia, SC 29223-6251
Phone
(803) 736-6262
Fax
(803) 699-1934
NPI assigned
Jun 20, 2006
Organization subpart
Yes
Parent organization
PALMETTO HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 27, 2007

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

Authorized official

Name
Mr. Darrell C Coven
Title
Finance Director of Business Dev.
Phone
(803) 296-7301

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

3000 NE Medical Park
Suite 209
Columbia, SC 29223-6251

Mailing address

PO Box 402145
Atlanta, GA 30384-2145
Phone (803) 296-7313

Other identifiers 1

IdentifierTypeStateIssuer
GP0039MedicaidSC

Other names 1

  • Northeast Family Practice Doing business as

National Provider Directory

National Provider Directory
Part of
Markowitz and Associates

Locations

3000 NE Medical Park
Ste 209
Columbia, SC 29223
Phone (803) 736-6262

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198713600000",
    "number": "1659316743",
    "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": "803-296-7313",
            "fax_number": "803-296-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 NE MEDICAL PARK",
            "address_2": "SUITE 209",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292236251",
            "telephone_number": "803-736-6262",
            "fax_number": "803-699-1934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PALMETTO HEALTH",
        "enumeration_date": "2006-06-20",
        "last_updated": "2007-12-27",
        "status": "A",
        "authorized_official_last_name": "COVEN",
        "authorized_official_first_name": "DARRELL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "FINANCE DIRECTOR OF BUSINESS DEV.",
        "authorized_official_telephone_number": "803-296-7301",
        "authorized_official_name_prefix": "Mr."
    },
    "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": "GP0039",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northeast Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 27, 2007; 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.