NPIMap

Organization Active NPI

Palmetto Pain Management LLC

  • Interventional Pain Medicine Physician
  • Columbia, SC
National Provider Identifier
1861411738
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
PALMETTO PAIN MANAGEMENT LLC
Practice address
2611 Forest Dr Ste 200
Columbia, SC 29204-2371
Phone
(803) 779-3263
Fax
(803) 779-3207
NPI assigned
Jul 19, 2006
Last updated
Sep 15, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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

Authorized official

Name
Christina B Smoak
Title
Credentialing
Phone
(803) 779-3263

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X NU Primary

Addresses

Primary practice location

2611 Forest Dr Ste 200
Columbia, SC 29204-2371

Mailing address

2611 Forest Dr Ste 200
Columbia, SC 29204-2371
Phone (803) 779-3263

Other identifiers 1

IdentifierTypeStateIssuer
138942MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110712000111 SC Part B Supplier - Clinic/Group Practice 9234307521 Receives reassigned benefits from 19 practitioners
Practice locations: Columbia, SC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789430400000",
    "number": "1861411738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2611 FOREST DR STE 200",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042371",
            "telephone_number": "803-779-3263",
            "fax_number": "803-779-3207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2611 FOREST DR STE 200",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042371",
            "telephone_number": "803-779-3263",
            "fax_number": "803-779-3207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO PAIN MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A",
        "authorized_official_last_name": "SMOAK",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "803-779-3263"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "138942",
            "state": "SC"
        }
    ],
    "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 Sep 15, 2026; 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.