NPIMap

Organization Active NPI

Palmetto OB/GYN Physicians, PA

  • Gynecology Physician
  • Summerville, SC
National Provider Identifier
1962767756
Registry record updated Jul 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
Legal business name
PALMETTO OB/GYN PHYSICIANS, PA
Practice address
104B Morgan PL
Summerville, SC 29485-8106
Phone
(843) 851-3800
Fax
(843) 851-7787
NPI assigned
Jul 9, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2012

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

Authorized official

Name
Deborah S. Bredestege, MDNPI 1871732289
Title
Owner
Phone
(843) 851-3800

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VG0400X SC Primary
Obstetrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VX0000X SC

Addresses

Primary practice location

104B Morgan PL
Summerville, SC 29485-8106

Mailing address

104B Morgan PL
Summerville, SC 29485-8106
Phone (843) 851-3800

National Provider Directory

National Provider Directory

Locations

104 Morgan Pl
Ste B
Summerville, SC 29485
Phone (843) 851-3800

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20947/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 6

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": "1341792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341792000000",
    "number": "1962767756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104B MORGAN PL",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858106",
            "telephone_number": "843-851-3800",
            "fax_number": "843-851-7787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104B MORGAN PL",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858106",
            "telephone_number": "843-851-3800",
            "fax_number": "843-851-7787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO OB/GYN PHYSICIANS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-09",
        "last_updated": "2012-07-09",
        "status": "A",
        "authorized_official_last_name": "BREDESTEGE",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-851-3800",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "SC",
            "license": null,
            "primary": true
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "SC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2012; 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.