Palmetto Pediatrics, PA

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PALMETTO PEDIATRICS, PA

Practice address

2781 Tricom St
North Charleston, SC 29406-9170

Phone

(843) 797-5600

NPI assigned

Dec 1, 2006

Organization subpart

No

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

Authorized official

Name

Sharon Chodnicki

Title

Practice Manager

Phone

(843) 797-5600

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

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

• John Bruce Etheridge, MD

  • Pediatrics Physician
  • Port Royal, SC
  • NPI 1861586414
  NPD (past)
• Michael L Leonardi, MD

  • Pediatrics Physician
  • Charleston, SC
  • NPI 1932295425
  NPD (past)
• Philip K. Lowe, MD

  • Pediatrics Physician
  • Charleston, SC
  • NPI 1548394224
  NPD (past)

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861560765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2781 TRICOM ST",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069170",
            "telephone_number": "843-797-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2781 TRICOM ST",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069170",
            "telephone_number": "843-797-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO PEDIATRICS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHODNICKI",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "843-797-5600"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP0233",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Palmetto Goodwill
• Palmetto Infusion Services, LLC
• Palmetto Lowcountry Behavioral Health, LLC
• Palmetto PA Assist, LLC
• Palmetto Pathway Support LLC
• Palmetto Plastic Surgery, P.a.
• Palmetto Primary Care Physicians, LLC
• Palmetto Speech & Language Assoc, LLC
• Palmetto Travel Medicine
• Palmetto Travel Medicine

• Pediatrics Physician in North Charleston, SC
• Providers in North Charleston, SC by specialty
• Pediatrics Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.

Verify at the official NPI Registry.