Individual provider Active NPI

John Stephen Rider, DC

  • Chiropractor
  • Irmo, SC
National Provider Identifier
1043867641
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4889 Issued in SC
Practice address
7839 Broad River Rd
Irmo, SC 29063-2357
Phone
(803) 732-3996
NPI assigned
Aug 20, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301010749 MI
Chiropractor 111N00000X 4889 SC Primary

Addresses

Primary practice location

7839 Broad River Rd
Irmo, SC 29063-2357

Mailing address

7839 Broad River Rd
Irmo, SC 29063-2357
Phone (803) 732-3996

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230130002477 SC Practitioner - Chiropractic 6709257769 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7839 Broad River Rd
Irmo, SC 29063-2357
Phone (803) 732-3996

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301010749MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dutch Fork Chiropractic Center PA Chiropractor CurrentSince Jul 13, 2025 Accepting new patients
Rider Family Chiropractic Chiropractor CurrentSince Dec 17, 2022 Accepting new patients
Optimum Health Chiropractic Center, PLLC Chiropractor PastSince Mar 28, 2021 Accepting new patients

Locations

7839 Broad River Rd
Irmo, SC 29063
Phone (803) 732-3996

Organizations & group practices 3

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": "1566259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1043867641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7839 BROAD RIVER RD",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290632357",
            "telephone_number": "803-732-3996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7839 BROAD RIVER RD",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290632357",
            "telephone_number": "803-732-3996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDER",
        "first_name": "JOHN",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-20",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301010749",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "4889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irmo, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2025; 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.