In-Moon Iris Park, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

SC5052 Issued in SC

Practice address

40 Saint Mark Rd
Taylors, SC 29687-5233

Phone

(864) 283-0600

NPI assigned

Jun 13, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Iris Park Professional name

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Group practices

Upper Cervical Spine Center LLCGroup PAC ID 0143481986, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Upper Cervical Spine Center, LLC

  • Chiropractor
  • Taylors, SC
  • NPI 1811260979
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1718236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1023851573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 SAINT MARK RD",
            "city": "TAYLORS",
            "state": "SC",
            "postal_code": "296875233",
            "telephone_number": "864-283-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 SAINT MARK RD",
            "city": "TAYLORS",
            "state": "SC",
            "postal_code": "296875233",
            "telephone_number": "864-283-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "IN-MOON",
        "middle_name": "IRIS",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-13",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "SC5052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IRIS",
            "last_name": "PARK",
            "credential": "DC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Maria Del Rosario Paniagua Alejo
• Patriot Living of Taylors, LLC
• Jaalah H Patterson
• Alexandra Patti
• Ashley Nicole Peace, NP
• Laure Pena, M.A., CCC-SLP

• Chiropractor in Taylors, SC
• Providers in Taylors, SC by specialty
• Chiropractor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.