Active NPI
Palmetto Plastic Surgery, P.a.
- Plastic Surgery Physician
- North Charleston, SC
National Provider Identifier
1811953847
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- Legal business name
- PALMETTO PLASTIC SURGERY, P.A.
- Practice address
- 2801 Tricom St
North Charleston, SC 29406-9172 - Phone
- (843) 797-5252
- Fax
- (843) 797-3683
- NPI assigned
- Apr 26, 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
- Ms. Karen Weiner
- Title
- Office Manager
- Phone
- (843) 797-5252
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | Primary |
Addresses
Primary practice location
2801 Tricom St
North Charleston, SC 29406-9172
Mailing address
2801 Tricom St
North Charleston, SC 29406-9172
Phone (843) 797-5252
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GP1404 | Medicaid | SC |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 42D2235731 | Palmetto Plastic Surgery | Certificate of waiver | Sep 9, 2027 |
National Provider Directory
National Provider DirectoryLocations
2801 Tricom St
North Charleston, SC 29406
Phone (843) 787-5252
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Plastic Surgery Physician
- North Charleston, SC
- NPI 1083663371
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146009600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1202342400000",
"number": "1811953847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2801 TRICOM ST",
"city": "NORTH CHARLESTON",
"state": "SC",
"postal_code": "294069172",
"telephone_number": "843-797-5252",
"fax_number": "843-797-3683"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2801 TRICOM ST",
"city": "NORTH CHARLESTON",
"state": "SC",
"postal_code": "294069172",
"telephone_number": "843-797-5252",
"fax_number": "843-797-3683"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PALMETTO PLASTIC SURGERY, P.A.",
"organizational_subpart": "NO",
"enumeration_date": "2006-04-26",
"last_updated": "2008-02-07",
"status": "A",
"authorized_official_last_name": "WEINER",
"authorized_official_first_name": "KAREN",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "843-797-5252",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Plastic Surgery",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GP1404",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in North Charleston, SC
- Palmetto Infusion Services, LLC (Palmetto Infusion Services)
- Palmetto Lowcountry Behavioral Health, LLC
- Palmetto PA Assist, LLC
- Palmetto Pathway Support LLC
- Palmetto Pediatrics, PA
- Palmetto Primary Care Physicians, LLC (Palmetto Advanced Therapy Services)
- Palmetto Speech & Language Assoc, LLC
- Palmetto Travel Medicine (Passport Health)
- Palmetto Travel Medicine (Passport Health)
- Nisha Pandya, MS, CGC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.