Brent D Carraway, DC

Individual provider Active NPI Chiropractor · Manning, SC

NPI 1104996255 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1104996255
Entity type
Individual (NPI type 1)
Primary specialty
Chiropractor 111N00000X
License
1857 (SC)
Practice address
601 B South Mill Street
Manning, SC 29102
Phone
(803) 435-4050
Fax
(803) 435-8096
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Medicare Care Compare profile

Specialty
Chiropractic
Education
Life Chiropractic College - West, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Health and Injury Clinic (3 clinicians)

Practice addresses (Care Compare)

711 Bultman Dr
Sumter, SC 29150-2516
Phone (803) 773-3421

Hospital & facility affiliations

  • McLeod Health Clarendon Hospital · Manning, SC · CCN 420109

Medicare participation

Medicare fee-for-service enrollment
Enrolled in SC

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20050919000847 SC Practitioner - Chiropractic 4486688512 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Health & Injury Clinic Chiropractor Current
since May 3, 1999
Accepting new patients

Locations

601 S Mill St
#B
Manning, SC 29102
Phone (803) 435-4050

711 Bultman Dr
Sumter, SC 29150
Phone (803) 773-3421

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1857 SC Yes

Addresses

Primary practice location

601 B South Mill Street
Manning, SC 29102

Mailing address

711 Bultman Drive
Sumter, SC 29150
Phone (803) 773-3421

Other providers in Manning, SC

All providers in Manning, SC · Chiropractor in South Carolina

Sources for this page

Verify at the official NPI Registry.