NPIMap

Organization Active NPI

Palmetto Health

Doing business as Palmetto Health Ophthalmology

  • Ophthalmology Physician
  • Columbia, SC
National Provider Identifier
1912242876
Registry record updated Sep 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
PALMETTO HEALTH
Doing business as
Palmetto Health Ophthalmology
Practice address
9 Richland Medical Park Dr
Suite 340
Columbia, SC 29203-6859
Phone
(803) 434-2020
Fax
(803) 434-1581
NPI assigned
Dec 4, 2012
Last updated
Sep 30, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
PALMETTO HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 30, 2014

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

Authorized official

Name
Mr. Darrell C Coven
Title
Director-Ambulatory Srvcs-Finance
Phone
(803) 296-7301

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

9 Richland Medical Park Dr
Suite 340
Columbia, SC 29203-6859

Mailing address

PO Box 402145
Atlanta, GA 30384-2145
Phone (803) 434-6836

Other identifiers 2

IdentifierTypeStateIssuer
GP6063MedicaidSC
DA9578MedicaidSC

Other names 1

  • Palmetto Health Ophthalmology Doing business as

National Provider Directory

National Provider Directory
Part of
Northeast Family Practi

NPI Registry JSON

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

{
    "created_epoch": "1354579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412035200000",
    "number": "1912242876",
    "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": "803-434-6836",
            "fax_number": "803-296-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 RICHLAND MEDICAL PARK DR",
            "address_2": "SUITE 340",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036859",
            "telephone_number": "803-434-2020",
            "fax_number": "803-434-1581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PALMETTO HEALTH",
        "enumeration_date": "2012-12-04",
        "last_updated": "2014-09-30",
        "status": "A",
        "authorized_official_last_name": "COVEN",
        "authorized_official_first_name": "DARRELL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DIRECTOR-AMBULATORY SRVCS-FINANCE",
        "authorized_official_telephone_number": "803-296-7301",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP6063",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DA9578",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palmetto Health Ophthalmology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 30, 2014; 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.