Organization Active NPI

Palmetto Vein & Aesthetic Center PA

  • Phlebology Physician
  • Lexington, SC
National Provider Identifier
1720205529
Registry record updated Mar 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Phlebology PhysicianTaxonomy code 202K00000X
Legal business name
PALMETTO VEIN & AESTHETIC CENTER PA
Practice address
4715 Sunset Blvd
Suite C
Lexington, SC 29072-9151
Phone
(803) 359-8346
Fax
(803) 359-0978
NPI assigned
Apr 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2009

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

Authorized official

Name
Paul M Espinoza, MD
Title
Physician
Phone
(803) 359-8346

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 202K00000X Primary

Addresses

Primary practice location

4715 Sunset Blvd
Suite C
Lexington, SC 29072-9151

Mailing address

4715 Sunset Blvd
Suite C
Lexington, SC 29072-9151
Phone (803) 359-8346

Other identifiers 1

IdentifierTypeStateIssuer
GP4726MedicaidSC

National Provider Directory

National Provider Directory

Locations

4721 Sunset Blvd
#D
Lexington, SC 29072
Phone (803) 425-1112

4715 Sunset Blvd
#C
Lexington, SC 29072
Phone (803) 356-8346

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236211200000",
    "number": "1720205529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4715 SUNSET BLVD",
            "address_2": "SUITE C",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290729151",
            "telephone_number": "803-359-8346",
            "fax_number": "803-359-0978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4715 SUNSET BLVD",
            "address_2": "SUITE C",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290729151",
            "telephone_number": "803-359-8346",
            "fax_number": "803-359-0978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO VEIN & AESTHETIC CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2009-03-05",
        "status": "A",
        "authorized_official_last_name": "ESPINOZA",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "803-359-8346",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Phlebology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4726",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2009; 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.