Organization Active NPI

Acacia Chiropractic Clinic PLLC

  • Chiropractor
  • Fort Mill, SC
National Provider Identifier
1063360675
Registry record updated Mar 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
ACACIA CHIROPRACTIC CLINIC PLLC
Practice address
1188 Stonecrest Blvd Ste 102
Fort Mill, SC 29708-6633
Phone
(803) 412-2240
Fax
(803) 802-2413
NPI assigned
Mar 19, 2026
Last updated
Mar 19, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2026

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

Authorized official

Name
Jared SamsNPI 1770020075
Title
Owner
Phone
(803) 412-2240

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X Primary

Addresses

Primary practice location

1188 Stonecrest Blvd Ste 102
Fort Mill, SC 29708-6633

Mailing address

10017 Glencrest Dr
Huntersville, NC 28078-5258
Phone (803) 412-2240

National Provider Directory

National Provider Directory

Locations

1188 Stonecrest Blvd
Ste 102
Tega Cay, SC 29708
Phone (803) 412-2240

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1773878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773878400000",
    "number": "1063360675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10017 GLENCREST DR",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280785258",
            "telephone_number": "803-412-2240",
            "fax_number": "803-802-2413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1188 STONECREST BLVD STE 102",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297086633",
            "telephone_number": "803-412-2240",
            "fax_number": "803-802-2413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACACIA CHIROPRACTIC CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-19",
        "last_updated": "2026-03-19",
        "certification_date": "2026-03-19",
        "status": "A",
        "authorized_official_last_name": "SAMS",
        "authorized_official_first_name": "JARED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-412-2240"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Mill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2026; 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.