NPIMap

Organization Active NPI

Palmetto Nephrology PA

  • Specialist
  • Orangeburg, SC
National Provider Identifier
1962433565
Registry record updated Aug 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
PALMETTO NEPHROLOGY PA
Practice address
3031 Saint Matthews Rd
Orangeburg, SC 29118-1443
Phone
(803) 531-2677
Fax
(803) 531-6137
NPI assigned
Jul 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2021

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

Authorized official

Name
Dr. Mohammad S Nassri, MDNPI 1275564965
Title
President
Phone
(803) 531-2677

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

3031 Saint Matthews Rd
Orangeburg, SC 29118-1443

Mailing address

3031 Saint Matthews Rd
Orangeburg, SC 29118-1443
Phone (803) 531-2677

Other identifiers 1

IdentifierTypeStateIssuer
GP3407MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041221000388 SC Part B Supplier - Clinic/Group Practice 9335107424 Receives reassigned benefits from 6 practitioners
Practice locations: Orangeburg, SC

National Provider Directory

National Provider Directory

Locations

1175 Cook Rd
Ste 1115
Orangeburg, SC 29118

3031 Saint Matthews Rd
Orangeburg, SC 29118
Phone (803) 531-2677

1175 Cook Rd
Ste 115
Orangeburg, SC 29118
Phone (803) 531-2677

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628121600000",
    "number": "1962433565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3031 SAINT MATTHEWS RD",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291181443",
            "telephone_number": "803-531-2677",
            "fax_number": "803-531-6137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3031 SAINT MATTHEWS RD",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291181443",
            "telephone_number": "803-531-2677",
            "fax_number": "803-531-6137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO NEPHROLOGY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A",
        "authorized_official_last_name": "NASSRI",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "803-531-2677",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3407",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orangeburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2021; 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.