NPIMap

Organization Active NPI

Palmetto Health

Doing business as Palmetto Health Orthopedics

  • Orthopaedic Surgery Physician
  • Columbia, SC
National Provider Identifier
1780005827
Registry record updated Sep 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
PALMETTO HEALTH
Doing business as
Palmetto Health Orthopedics
Practice address
14 Richland Medical Park Dr
Suite 200
Columbia, SC 29203-6877
Phone
(803) 296-2663
Fax
(803) 296-2664
NPI assigned
Dec 16, 2013
Last updated
Sep 30, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
PALMETTO HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 30, 2016

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

Authorized official

Name
Darrell Coven
Title
Director, Bus Finance
Phone
(803) 296-7301

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X SC Primary
Orthopaedic Hand Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0106X SC
Orthopaedic Foot and Ankle Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XX0004X SC

Addresses

Primary practice location

14 Richland Medical Park Dr
Suite 200
Columbia, SC 29203-6877

Mailing address

PO Box 848932
Boston, MA 02284-8932
Phone (803) 296-7303

Other identifiers 1

IdentifierTypeStateIssuer
GP6908MedicaidSC

Other names 1

  • Palmetto Health Orthopedics Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031110000506 SC Part B Supplier - Clinic/Group Practice 6800708330 Receives reassigned benefits from 364 practitioners
17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Columbia, SC

Other NPIs on the same Medicare enrollment 17

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 17

National Provider Directory

National Provider Directory
Part of
Ridge Pediatric Adolesc

Locations

14 Richland Medical Park Dr
Ste 200
Columbia, SC 29203
Phone (803) 296-9200

Practitioners & affiliated clinicians

Practitioners 37

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1387152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475193600000",
    "number": "1780005827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 848932",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022848932",
            "telephone_number": "803-296-7303",
            "fax_number": "803-296-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 RICHLAND MEDICAL PARK DR",
            "address_2": "SUITE 200",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036877",
            "telephone_number": "803-296-2663",
            "fax_number": "803-296-2664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PALMETTO HEALTH",
        "enumeration_date": "2013-12-16",
        "last_updated": "2016-09-30",
        "status": "A",
        "authorized_official_last_name": "COVEN",
        "authorized_official_first_name": "DARRELL",
        "authorized_official_title_or_position": "DIRECTOR, BUS FINANCE",
        "authorized_official_telephone_number": "803-296-7301"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "SC",
            "license": null,
            "primary": true
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "SC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP6908",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palmetto Health Orthopedics",
            "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 Sep 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.