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PALMETTO OBGYN LLC
NPI 1275169807
Obstetrics & Gynecology in Myrtle Beach, SC

Active since March 16, 2020CLIA 42D2188880 · Microscopy
3864 RENEE DRIVE, MYRTLE BEACH, SC 29579(843) 353-2111(843) 628-4326 Get Directions Write a Review

NPPES record last updated: October 16, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 16, 2020, Mar 16, 2020 (2 updates tracked since 2020).

About Palmetto Obgyn Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PALMETTO OBGYN LLC (NPI 1275169807) is a healthcare organization registered as an obstetrics & gynecology in Myrtle Beach, South Carolina and active in the NPI registry since March 2020. The organization holds a CLIA Microscopy certificate valid through July 22, 2028 and lists Olubunmi Ashabi Alo, Md, as its authorized official.

NPPES Registry Identity

NPI1275169807
Entity TypeOrganization
Primary Taxonomy207V00000X
Legal Business NamePALMETTO OBGYN LLC
Location Address3864 RENEE DRIVEMyrtle Beach, SC 29579
Mailing AddressPo Box 51827Myrtle Beach, SC 29579-0031 · (843) 353-2111 · Fax (843) 628-4326
Phone(843) 353-2111
Fax(843) 628-4326
Organization SubpartNo
Authorized OfficialOlubunmi Ashabi AloMd · (843) 353-2111
Enumeration DateMarch 16, 2020
Last NPPES UpdateOctober 16, 20202 updates tracked since enumeration
NPPES CertifiedAugust 22, 2020
✔ NPI 1275169807 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
3864 RENEE DRIVE, Myrtle Beach, SC 29579
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Other Identifiers 1

MedicaidGP9634SC

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 42D2188880

Palmetto Obgyn LLC · Myrtle Beach, SC
Active · expires Jul 22, 2028
CLIA Number42D2188880
Laboratory TypePhysician Office
Certificate Effective DateJuly 23, 2026
Certificate Expiration DateJuly 22, 2028
Laboratory DirectorOlubunmi Alo
Laboratory Phone(843) 353-2111
Laboratory LocationPalmetto Obgyn LLC3864 Renee Drive, Myrtle Beach, SC 29579
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. OLUBUNMI ASHABI ALO M.D.
Obstetrics & Gynecology
3864 RENEE DRIVE
MYRTLE BEACH, SC 29579
Horry County (843) 353-2111

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Palmetto Obgyn LLC's NPI number?

The NPI number for Palmetto Obgyn LLC is 1275169807. It was assigned to this organization in the NPPES registry on March 16, 2020.

Where is Palmetto Obgyn LLC located?

Palmetto Obgyn LLC is located at 3864 Renee Drive, Myrtle Beach, SC 29579. The listed phone number is (843) 353-2111.

What is Palmetto Obgyn LLC's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Does Palmetto Obgyn LLC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 42D2188880) is associated with this NPI, valid through July 22, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Palmetto Obgyn LLC accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina, First Choice Next and Molina Healthcare list Palmetto Obgyn LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Palmetto Obgyn LLC was last updated on October 16, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.