NPIMap

Individual provider Active NPI

Kimberly Brooke Wheaton, D.C.

  • Chiropractor
  • Charleston, SC
National Provider Identifier
1003108093
Registry record updated Feb 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3710 Issued in SC
Practice address
811 Saint Andrews Blvd
Suite a
Charleston, SC 29407-7187
Phone
(843) 225-5855
NPI assigned
May 9, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3710 SC Primary

Addresses

Primary practice location

811 Saint Andrews Blvd
Suite a
Charleston, SC 29407-7187

Mailing address

811 Saint Andrews Blvd
Suite a
Charleston, SC 29407-7187
Phone (843) 225-5855

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3710SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Youngblood Chiropractic, PC Chiropractor Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1304899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329955200000",
    "number": "1003108093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 SAINT ANDREWS BLVD",
            "address_2": "SUITE A",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294077187",
            "telephone_number": "843-225-5855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 SAINT ANDREWS BLVD",
            "address_2": "SUITE A",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294077187",
            "telephone_number": "843-225-5855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEATON",
        "first_name": "KIMBERLY",
        "middle_name": "BROOKE",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-09",
        "last_updated": "2012-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "3710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.