Organization Active NPI

Wellnessplus P a

  • Chiropractor
  • Charleston, SC
National Provider Identifier
1083873780
Registry record updated Feb 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1009 Issued in SC
Legal business name
WELLNESSPLUS P A
Practice address
1001 - A Physicians Dr
Charleston, SC 29414-5746
Phone
(843) 571-1020
Fax
(843) 573-0788
NPI assigned
Jun 6, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2012

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

Authorized official

Name
Dr. Valerie Fantino, DCNPI 1700848959
Title
Chiropractor
Phone
(843) 571-1020

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 1009 SC Primary

Addresses

Primary practice location

1001 - A Physicians Dr
Charleston, SC 29414-5746

Mailing address

1001-A Physicians Drive
Charleston, SC 29414-5746
Phone (843) 571-1020

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040115000370 SC Part B Supplier - Clinic/Group Practice 8022919893 Receives reassigned benefits from 1 practitioner
Practice locations: Charleston, SC

National Provider Directory

National Provider Directory

Locations

1001 Physicians Dr
#A
Charleston, SC 29414
Phone (843) 571-1020

1119 Wappoo Rd
Unit A
Charleston, SC 29407
Phone (843) 571-1020

Practitioners & affiliated clinicians

Practitioners 3

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": "1212710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329350400000",
    "number": "1083873780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001-A PHYSICIANS DRIVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145746",
            "telephone_number": "843-571-1020",
            "fax_number": "843-573-0788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 - A PHYSICIANS DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145746",
            "telephone_number": "843-571-1020",
            "fax_number": "843-573-0788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESSPLUS P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-06",
        "last_updated": "2012-02-16",
        "status": "A",
        "authorized_official_last_name": "FANTINO",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "843-571-1020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "1009",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Feb 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.