Palmetto Senior Care Shandon

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

19802 Issued in SC

Legal business name

PALMETTO SENIOR CARE SHANDON

Practice address

1100 Shirley St Ste 1
Columbia, SC 29205-1370

Phone

(803) 252-1979

NPI assigned

Apr 26, 2016

Organization subpart

Yes

Parent organization

PALMETTO HEALTHAs reported in NPPES

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

Authorized official

Name

Dr. John Egbert, MD, PHD

Title

Pace Executive MD

Phone

(803) 252-1979

Specialties & licenses 1

Addresses

Part of

Markowitz and Associates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Louis Bussells, APRN

  • Family Nurse Practitioner
  • West Columbia, SC
  • NPI 1043665821
  NPD (past)

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

{
    "created_epoch": "1461628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461628800000",
    "number": "1801241971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 SHIRLEY ST STE 1",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292051370",
            "telephone_number": "803-252-1979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 SHIRLEY ST STE 1",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292051370",
            "telephone_number": "803-252-1979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO SENIOR CARE SHANDON",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PALMETTO HEALTH",
        "enumeration_date": "2016-04-26",
        "last_updated": "2016-04-26",
        "status": "A",
        "authorized_official_last_name": "EGBERT",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PACE EXECUTIVE MD",
        "authorized_official_telephone_number": "803-252-1979",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "SC",
            "license": "19802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Palmetto Project Counseling Group
• Palmetto Psychiatry Consultants, LLC
• Palmetto Ride Care
• Palmetto RX Solutions Inc
• Palmetto Senior Care at Home LLC
• Palmetto Southern Comfort Diagnostics (PSC Diagnostics)
• Palmetto Southern Comfort Home Care
• Palmetto Specialty Long Term Care
• Palmetto Speech Language Literacy Group, LLC
• Palmetto Spinal Center, LLC

• Adult Care Home Facility in Columbia, SC
• Providers in Columbia, SC by specialty
• Adult Care Home Facility in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2016; 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.