Individual provider Active NPI

Renatta Nicole Palmore, NP

  • Women's Health Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1821488099
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
18926 Issued in SC
Practice address
9 Richland Medical Park Dr Ste 620
Columbia, SC 29203-6845
Phone
(803) 779-6776
NPI assigned
Jan 27, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209-016828 IL
Nurse Practitioner 363L00000X 18926 SC
Women's Health Nurse Practitioner 363LW0102X 18926 SC Primary

Addresses

Primary practice location

9 Richland Medical Park Dr Ste 620
Columbia, SC 29203-6845

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842

Other identifiers 1

IdentifierTypeStateIssuer
NP7630MedicaidSC

Other names 1

  • Ms. Renatta Nicole White Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161212000792 SC Practitioner - Nurse Practitioner 6002196987 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health Medical Group-MidlandsGroup PAC ID 5991099707, 1,040 clinicians

Practice addresses (Care Compare)

9 Richland Medical Park Dr
Suite 210
Columbia, SC 29203-6859
Phone (803) 935-5604

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209-016828ILMDNurse Practitioner
18926SCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands CurrentSince May 1, 2021 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince May 1, 2021 Accepting new patients
Premier Counseling CurrentSince Oct 6, 2016 Accepting new patients

Locations

9 Richland Medical Park Dr
Ste 620
Columbia, SC 29203
Phone (803) 779-6776

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

4711 Forest Dr
Ste 3
Columbia, SC 29206
Phone (646) 450-8990

9 Richland Medical Park Dr
Ste 210
Columbia, SC 29203
Phone (803) 434-6598

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

Interoperability endpoints

  • Direct secure messaging: rpalmore507313@direct.ghs.myhfn.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1422316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1821488099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 RICHLAND MEDICAL PARK DR STE 620",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036845",
            "telephone_number": "803-779-6776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMORE",
        "first_name": "RENATTA",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-27",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209-016828",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "18926",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "SC",
            "license": "18926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP7630",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENATTA",
            "last_name": "WHITE",
            "middle_name": "NICOLE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.