Individual provider Active NPI

Thomas Ian Medlin, DC

  • Chiropractor
  • Greer, SC
National Provider Identifier
1043843923
Registry record updated Feb 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4528 Issued in SC
Practice address
140 Sage Creek Way
Greer, SC 29650-0957
Phone
(864) 848-0640
NPI assigned
Feb 19, 2020
Last updated
Feb 19, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4528 SC Primary

Addresses

Primary practice location

140 Sage Creek Way
Greer, SC 29650-0957

Mailing address

469 Belcher Rd
Boiling Springs, SC 29316-8368
Phone (954) 513-8381

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
4528SCMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Enhanced Living-Simpsonville Chiropractic, LLC Chiropractor CurrentSince Nov 22, 2020 Accepting new patients
The Wellness Place Chiropractor Past Accepting new patients

Locations

140 Sage Creek Way
Greer, SC 29650
Phone (864) 846-0640

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1582070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582070400000",
    "number": "1043843923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "469 BELCHER RD",
            "city": "BOILING SPRINGS",
            "state": "SC",
            "postal_code": "293168368",
            "telephone_number": "954-513-8381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 SAGE CREEK WAY",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296500957",
            "telephone_number": "864-848-0640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDLIN",
        "first_name": "THOMAS",
        "middle_name": "IAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-19",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "4528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greer, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2020; 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.