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PALMETTO ADULT AND CHILDRENS UROLOGY PA
NPI 1336928282
Non-Pharmacy Dispensing Site in North Charleston, SC

Active since September 28, 2023CLIA Certified · 2 labs
2890 TRICOM ST, NORTH CHARLESTON, SC 29406(843) 797-6600(843) 820-1440 Get Directions Write a Review

NPPES record last updated: September 28, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Palmetto Adult And Childrens Urology Pa NPPES

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

PALMETTO ADULT AND CHILDRENS UROLOGY PA (NPI 1336928282) is a healthcare organization registered as a non-pharmacy dispensing site in North Charleston, South Carolina and active in the NPI registry since September 2023. The organization holds 2 active CLIA laboratory certificates and lists Amelia Munkberg, Practice Administrator, as its authorized official.

NPPES Registry Identity

NPI1336928282
Entity TypeOrganization
Primary Taxonomy332900000X
Legal Business NamePALMETTO ADULT AND CHILDRENS UROLOGY PA
Location Address2890 TRICOM STNorth Charleston, SC 29406-9171
Mailing Address2890 Tricom StNorth Charleston, SC 29406-9171 · (843) 797-6600 · Fax (843) 820-1440
Phone(843) 797-6600
Fax(843) 820-1440
Organization SubpartNo
Authorized OfficialAmelia MunkbergPractice Administrator · (843) 797-6600
Enumeration DateSeptember 28, 2023
NPPES CertifiedSeptember 28, 2023
✔ NPI 1336928282 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers
Taxonomy Code332900000X
Definition
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
2890 TRICOM ST, North Charleston, SC 29406
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA 3

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 of Waiver 42D2179416

Palmetto Adult And Children's Urology · Summerville, SC
Active · expires Feb 23, 2028
CLIA Number42D2179416
Laboratory TypePhysician Office
Certificate Effective DateFebruary 24, 2026
Certificate Expiration DateFebruary 23, 2028
Laboratory DirectorDr. Nelson R. Ploch
Laboratory Phone(843) 797-6600
Laboratory LocationPalmetto Adult And Children's Urology5500 Front Street, Ste 250, Summerville, SC 29486
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 42D0251419

Palmetto Adult And Children's Urology · Walterboro, SC
Active · expires Aug 31, 2026
CLIA Number42D0251419
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorTheodore E. Brisson
Laboratory Phone(843) 797-6600
Laboratory LocationPalmetto Adult And Children's Urology302 Medical Park Drive Suite 207, Walterboro, SC 29488
CLIA data matches this NPI record on: 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.

Certificate of Compliance 42D0250964

Palmetto Adult And Children's Urology, PA · North Charleston, SC
Expired · Jul 31, 2026
CLIA Number42D0250964
Laboratory TypePhysician Office
Certificate Effective DateFebruary 15, 2023
Certificate Expiration DateJuly 31, 2026
Laboratory DirectorMelanie A. Hopkins
Laboratory Phone(843) 797-6600
Laboratory LocationPalmetto Adult And Children's Urology, PA2890 Tricom Street, North Charleston, SC 29406
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 7

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

MS. GRACE ELIZABETH HOWIE PA
Physician Assistant
2890 TRICOM ST
NORTH CHARLESTON, SC 29406
Charleston County (843) 797-6600
CAMERON DUVALL
Urology
2890 TRICOM ST
NORTH CHARLESTON, SC 29406
Charleston County (843) 797-6600
GUILLAUME FARAH
Student in an Organized Health Care Education/Training Program
2890 TRICOM ST
NORTH CHARLESTON, SC 29406
Charleston County (843) 797-6600
DR. SAMUEL WALKER NICKLES M.D.
Urology
2890 TRICOM ST
NORTH CHARLESTON, SC 29406
Charleston County (843) 797-6600
PALMETTO ADULT AND CHILDRENS UROLOGY PA
Urology
2890 TRICOM ST
NORTH CHARLESTON, SC 29406
Charleston County (843) 797-6600
DR. TAYLOR B VAUGHAN MD
Urology
2890 TRICOM ST
NORTH CHARLESTON, SC 29406
Charleston County (843) 797-6600
DWAYNE VALENTINO FORD APRN, FNP-C
Nurse Practitioner (Family)
2890 TRICOM ST
NORTH CHARLESTON, SC 29406
Charleston County (843) 797-6600

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 Adult And Childrens Urology PA's NPI number?

The NPI number for Palmetto Adult And Childrens Urology PA is 1336928282. It was assigned to this organization in the NPPES registry on September 28, 2023.

Where is Palmetto Adult And Childrens Urology PA located?

Palmetto Adult And Childrens Urology PA is located at 2890 Tricom St, North Charleston, SC 29406. The listed phone number is (843) 797-6600.

What is Palmetto Adult And Childrens Urology PA's specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

Does Palmetto Adult And Childrens Urology PA hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Palmetto Adult And Childrens Urology PA accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 33 other insurers list Palmetto Adult And Childrens Urology PA 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 Adult And Childrens Urology PA was last updated on September 28, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.