Active NPI
William Mark Luckie, D.C.
- Chiropractor
- Charleston, SC
National Provider Identifier
1083641914
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2265
- 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, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 043648008 | Other | SC | FIN |
| CH2265 | Medicaid | SC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2265 | SC | MD | Endodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Charleston Non Surgical Center | Chiropractor | Past | Accepting new patients |
| Lowcountry Neuropathy of Beaufort LLC | Past | Accepting new patients | |
| Eterna Aesthetics and Wellness | Past | Accepting new patients | |
| Lowcountry Neuropathy of Hilton Head, LLC | Past | Accepting new patients | |
| West Ashley Wellness & Rehabilitation, LLC | Past | 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.
-
- Family Medicine Physician
- Beaufort, SC
- NPI 1396094637
-
- Family Medicine Physician
- Bluffton, SC
- NPI 1700134186
-
- Chiropractor
- Charleston, SC
- NPI 1013903970
-
- Health Service Clinic/Center
- Charleston, SC
- NPI 1568357465
-
- Rehabilitation Practitioner
- Charleston, SC
- NPI 1962726117
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.