Active NPI
Palmetto Family Care
- Family Medicine Physician
- North Charleston, SC
National Provider Identifier
1790765972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- SC12512
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Herold Nazon, M.D.
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GP2608 | Medicaid | SC |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Family Medicine Physician
- Summerville, SC
- NPI 1184804536
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.