Palmetto Health

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PALMETTO HEALTH

Doing business as

Parkridge Medical Associates

Practice address

100 Palmetto Health Parkway
Suite 220
Columbia, SC 29212-1755

Phone

(803) 749-0693

Fax

(803) 749-3986

NPI assigned

Sep 24, 2012

Last updated

Jun 29, 2016By the provider in NPPES

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

Darrell C Coven

Title

Director, Ambulatory Services, Fin.

Phone

(803) 296-7301

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Parkridge Medical Associates Doing business as

Part of

Northeast Family Practi

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Palmetto Health

  dba Palmetto Health Orthopedics

  • Orthopaedic Surgery Physician
  • Columbia, SC
  • NPI 1972054021

  Member Of

  NPD member

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

{
    "created_epoch": "1348444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467158400000",
    "number": "1851642458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 402145",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303842145",
            "telephone_number": "803-296-7305",
            "fax_number": "803-296-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PALMETTO HEALTH PARKWAY",
            "address_2": "SUITE 220",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292121755",
            "telephone_number": "803-749-0693",
            "fax_number": "803-749-3986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PALMETTO HEALTH",
        "enumeration_date": "2012-09-24",
        "last_updated": "2016-06-29",
        "status": "A",
        "authorized_official_last_name": "COVEN",
        "authorized_official_first_name": "DARRELL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DIRECTOR, AMBULATORY SERVICES, FIN.",
        "authorized_official_telephone_number": "803-296-7301"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP6103",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Parkridge Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Palmetto Health (ColoRectal Associates)
• Palmetto Health (Palmetto Health Counseling - Spring Valley)
• Palmetto Health (Pediatric Hematology/Oncology)
• Palmetto Health (Baptist Inpatient Medical Associates)
• Palmetto Health (Palmetto Healthy Start)
• Palmetto Health (Orthopaedic and Spine Surgeons of South Carolina)
• Palmetto Health (Palmetto Infectious Disease)
• Palmetto Health (Palmetto Health Urgent Care)
• Palmetto Health (Pediatric Rheumatology)
• Palmetto Health

• Family Medicine Physician in Columbia, SC
• Providers in Columbia, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.