Individual provider Active NPI

Suzzanne Mabel Candelaria Perez, DC

  • Chiropractor
  • Spartanburg, SC
National Provider Identifier
1063164341
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4769 Issued in SC
Practice address
201 S Dean St
Spartanburg, SC 29302-1986
Phone
(864) 583-3967
Fax
(864) 585-5554
NPI assigned
Jan 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4769 SC Primary

Addresses

Primary practice location

201 S Dean St
Spartanburg, SC 29302-1986

Mailing address

201 S Dean St
Spartanburg, SC 29302-1986
Phone (864) 583-3967

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220203000499 SC Practitioner - Chiropractic 1850784463 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivey Osullivan Healthcare Services, PAGroup PAC ID 9537326681, 3 clinicians

Practice addresses (Care Compare)

201 S Dean St
Spartanburg, SC 29302-1986
Phone (864) 583-3967

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ivey-Osullivan Healthcare Services, PA Chiropractor CurrentSince Jan 26, 2022 Accepting new patients
Garber Physical Therapy PastSince Jan 26, 2022 Accepting new patients

Locations

201 S Dean St
Spartanburg, SC 29302
Phone (864) 583-3967

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1642550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1063164341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S DEAN ST",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293021986",
            "telephone_number": "864-583-3967",
            "fax_number": "864-585-5554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S DEAN ST",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293021986",
            "telephone_number": "864-583-3967",
            "fax_number": "864-585-5554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANDELARIA PEREZ",
        "first_name": "SUZZANNE",
        "middle_name": "MABEL",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-19",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "4769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; 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.