Organization Active NPI

Palmetto Imaging, Inc

  • Diagnostic Radiology Physician
  • Columbia, SC
National Provider Identifier
1790955888
Registry record updated Mar 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
PALMETTO IMAGING, INC
Practice address
3010 Farrow Rd
Suite 100
Columbia, SC 29204-7603
Phone
(770) 300-0101
Fax
(770) 300-0429
NPI assigned
Mar 5, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2008

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

Authorized official

Name
Mr. Daniel J Schaefer
Title
Coo
Phone
(770) 300-0101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

3010 Farrow Rd
Suite 100
Columbia, SC 29204-7603

Mailing address

PO Box 70609
North Charleston, SC 29415-0609
Phone (770) 300-0101

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040913000181 SC Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 4284601188 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Florence, SC

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Locations

3010 Farrow Rd
Ste 100
Columbia, SC 29203
Phone (803) 434-7750

NPI Registry JSON

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

{
    "created_epoch": "1204675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204675200000",
    "number": "1790955888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70609",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294150609",
            "telephone_number": "770-300-0101",
            "fax_number": "770-300-0429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 FARROW RD",
            "address_2": "SUITE 100",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292047603",
            "telephone_number": "770-300-0101",
            "fax_number": "770-300-0429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO IMAGING, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-05",
        "last_updated": "2008-03-05",
        "status": "A",
        "authorized_official_last_name": "SCHAEFER",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "770-300-0101",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Mar 5, 2008; 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.