Active NPI
Palmetto Vein & Aesthetic Center PA
- Phlebology Physician
- Lexington, SC
National Provider Identifier
1720205529
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Phlebology Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Phlebology Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GP4726 | Medicaid | SC |
National Provider Directory
National Provider DirectoryLocations
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.