NPIMap

Organization Active NPI

Palmetto Primary Care Physicians, LLC

  • Clinical Medical Laboratory
  • N Charleston, SC
National Provider Identifier
1659660645
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
PALMETTO PRIMARY CARE PHYSICIANS, LLC
Practice address
2500 Elms Center Rd
N Charleston, SC 29406-9844
Phone
(843) 572-7727
Fax
(843) 569-5881
NPI assigned
Mar 31, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Education NutritionistGroup: 193200000X MULTI-SPECIALTY GROUP 133NN1002X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

2500 Elms Center Rd
N Charleston, SC 29406-9844

Mailing address

PO Box 53062
Atlanta, GA 30355-1062
Phone (843) 695-6071

Other identifiers 2

IdentifierTypeStateIssuer
GP5897MedicaidSC
DPE089MedicaidSC

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

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
42D0251357Palmetto Primary Care Physicians-Central Lab2500 Elms Center Rd, North Charleston, SC 29406ComplianceAug 10, 2026

National Provider Directory

National Provider Directory
Tax ID family
Palmetto Primary Care P35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

Organizations that report the same tax identification number in the National Provider Directory.

View all 34

Practitioners & affiliated clinicians

Practitioners 7

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": "1301529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622592000000",
    "number": "1659660645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 53062",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303551062",
            "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": "2500 ELMS CENTER RD",
            "city": "N CHARLESTON",
            "state": "SC",
            "postal_code": "294069844",
            "telephone_number": "843-572-7727",
            "fax_number": "843-569-5881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO PRIMARY CARE PHYSICIANS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-31",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "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": "133NN1002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP5897",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DPE089",
            "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 2, 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.