Daniel a Koontz

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

11429 Issued in SC

Legal business name

DANIEL A KOONTZ

Doing business as

Palmetto Family Medicine Center

Practice address

323 Lebby St
Pelzer, SC 29669-1754

Phone

(864) 947-6666

Fax

(864) 947-8621

NPI assigned

Mar 6, 2007

Last updated

Aug 18, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Sandra B Koontz

Title

Office Manager

Phone

(864) 947-6666

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• PALMETTO FAMILY MEDICINE CENTER Doing business as

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219017600000",
    "number": "1912037672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 LEBBY ST",
            "city": "PELZER",
            "state": "SC",
            "postal_code": "296691754",
            "telephone_number": "864-947-6666",
            "fax_number": "864-947-8621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 LEBBY ST",
            "city": "PELZER",
            "state": "SC",
            "postal_code": "296691754",
            "telephone_number": "864-947-6666",
            "fax_number": "864-947-8621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL A KOONTZ",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2008-08-18",
        "status": "A",
        "authorized_official_last_name": "KOONTZ",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "864-947-6666",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "11429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114290",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "060035928",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PALMETTO FAMILY MEDICINE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Pelzer, SC
• Providers in Pelzer, 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 Aug 18, 2008; 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.