Organization Active NPI

Palmetto Family Care

  • Family Medicine Physician
  • North Charleston, SC
National Provider Identifier
1790765972
Registry record updated Oct 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
SC12512 Issued in SC
Legal business name
PALMETTO FAMILY CARE
Practice address
1455 Remount Rd
Suite 1a & 1B
North Charleston, SC 29406-3355
Phone
(843) 745-9990
Fax
(843) 745-0008
NPI assigned
Jan 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2007

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

Authorized official

Name
Dr. Herold Nazon, M.D.NPI 1184804536
Title
President
Phone
(843) 745-9990

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X SC12512 SC Primary

Addresses

Primary practice location

1455 Remount Rd
Suite 1a & 1B
North Charleston, SC 29406-3355

Mailing address

PO Box 50519
Summerville, SC 29485-0519
Phone (843) 745-9990

Other identifiers 1

IdentifierTypeStateIssuer
GP2608MedicaidSC

National Provider Directory

National Provider Directory

Locations

1455 Remount Rd
Ste 1A
North Charleston, SC 29406
Phone (843) 745-9990

Practitioners & affiliated clinicians

Practitioners 1

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": "1137888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192665600000",
    "number": "1790765972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50519",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294850519",
            "telephone_number": "843-745-9990",
            "fax_number": "843-745-0008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 REMOUNT RD",
            "address_2": "SUITE 1A & 1B",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294063355",
            "telephone_number": "843-745-9990",
            "fax_number": "843-745-0008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO FAMILY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-22",
        "last_updated": "2007-10-18",
        "status": "A",
        "authorized_official_last_name": "NAZON",
        "authorized_official_first_name": "HEROLD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-745-9990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "SC12512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2608",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.