Active NPI
Jerald G Yaden, DC
- Chiropractor
- Moncks Corner, SC
National Provider Identifier
1033171038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1432
- Practice address
- 425 Barony St
Moncks Corner, SC 29461 - Phone
- (843) 899-7933
- Fax
- (843) 899-5796
- NPI assigned
- Apr 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1432 | SC | Primary |
Addresses
Primary practice location
425 Barony St
Moncks Corner, SC 29461
Mailing address
425 Barony Street
Moncks Corner, SC 29461
Phone (843) 899-7933
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CH1432 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Cleveland Chiropractic College - Los Angeles, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
425 Barony St
Moncks Corner, SC 29461-3128
Phone (843) 899-7933
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Networks
- devoted network organization-92131eb0-09f2-4173-a140-cf7b381f0cf1
Interoperability endpoints
- jerald.yaden.1@30583.direct.athenahealth.com
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.
-
- Family Medicine Physician
- Moncks Corner, SC
- NPI 1255958658
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710115200000",
"number": "1033171038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "425 BARONY STREET",
"city": "MONCKS CORNER",
"state": "SC",
"postal_code": "29461",
"telephone_number": "843-899-7933",
"fax_number": "843-899-5796"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "425 BARONY ST",
"city": "MONCKS CORNER",
"state": "SC",
"postal_code": "29461",
"telephone_number": "843-899-7933",
"fax_number": "843-899-5796"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YADEN",
"first_name": "JERALD",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-05",
"last_updated": "2024-03-11",
"certification_date": "2024-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "SC",
"license": "1432",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "CH1432",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Moncks Corner, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.