Organization Active NPI

Clarendon Memorial Hospital

Doing business as Palmetto Women's Healthcare

  • Obstetrics & Gynecology Physician
  • Manning, SC
National Provider Identifier
1962704056
Registry record updated Jan 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
CLARENDON MEMORIAL HOSPITAL
Doing business as
Palmetto Women's Healthcare
Practice address
21 E Hospital St
Manning, SC 29102-3152
Phone
(803) 433-0797
Fax
(803) 433-0896
NPI assigned
Nov 23, 2010
Last updated
Jan 19, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
CLARENDON MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 19, 2011

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

Authorized official

Name
Mrs. Julie S Nettles
Title
Director
Phone
(803) 435-5270

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X NU Primary

Addresses

Primary practice location

21 E Hospital St
Manning, SC 29102-3152

Mailing address

21 E Hospital St
Manning, SC 29102-3152
Phone (803) 433-0797

Other identifiers 1

IdentifierTypeStateIssuer
GP5575MedicaidSC

Other names 1

  • Palmetto Women's Healthcare Doing business as

National Provider Directory

National Provider Directory
Part of
Clarenoon Memorial Hosp

NPI Registry JSON

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

{
    "created_epoch": "1290470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295395200000",
    "number": "1962704056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 E HOSPITAL ST",
            "city": "MANNING",
            "state": "SC",
            "postal_code": "291023152",
            "telephone_number": "803-433-0797",
            "fax_number": "803-433-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 E HOSPITAL ST",
            "city": "MANNING",
            "state": "SC",
            "postal_code": "291023152",
            "telephone_number": "803-433-0797",
            "fax_number": "803-433-0896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARENDON MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CLARENDON MEMORIAL HOSPITAL",
        "enumeration_date": "2010-11-23",
        "last_updated": "2011-01-19",
        "status": "A",
        "authorized_official_last_name": "NETTLES",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "803-435-5270",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP5575",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palmetto Women's Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manning, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2011; 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.