Individual provider Active NPI

William Mark Luckie, D.C.

  • Chiropractor
  • Charleston, SC
National Provider Identifier
1083641914
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2265 Issued in SC
Practice address
1692 Old Towne Rd
Charleston, SC 29407-5045
Phone
(843) 571-3100
Fax
(843) 766-7798
NPI assigned
Jun 27, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2265 SC Primary

Addresses

Primary practice location

1692 Old Towne Rd
Charleston, SC 29407-5045

Mailing address

1692 Old Towne Rd
Charleston, SC 29407-5045
Phone (843) 571-3100

Other identifiers 2

IdentifierTypeStateIssuer
043648008OtherSCFIN
CH2265MedicaidSC

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
2265SCMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Non Surgical Center Chiropractor PastSince Apr 2, 2004 Accepting new patients
Lowcountry Neuropathy of Beaufort LLC PastSince Feb 1, 2013 Accepting new patients
Eterna Aesthetics and Wellness PastSince Dec 1, 2024 Accepting new patients
Lowcountry Neuropathy of Hilton Head, LLC PastSince Oct 9, 2012 Accepting new patients
West Ashley Wellness & Rehabilitation, LLC PastSince Feb 22, 2010 Accepting new patients

Organizations & group practices 5

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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1083641914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1692 OLD TOWNE RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294075045",
            "telephone_number": "843-571-3100",
            "fax_number": "843-766-7798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1692 OLD TOWNE RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294075045",
            "telephone_number": "843-571-3100",
            "fax_number": "843-766-7798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCKIE",
        "first_name": "WILLIAM",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "2265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIN",
            "identifier": "043648008",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CH2265",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.