Quattlebaum Chiropractic

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

3095 Issued in SC

Legal business name

QUATTLEBAUM CHIROPRACTIC

Practice address

283 Dorchester Manor Blvd
North Charleston, SC 29420-8108

Phone

(843) 552-8000

Fax

(843) 552-0093

NPI assigned

Jun 17, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Brian Quattlebaum, DC

Title

Owner

Phone

(843) 552-8000

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1276732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281571200000",
    "number": "1114248739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "283 DORCHESTER MANOR BLVD",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294208108",
            "telephone_number": "843-552-8000",
            "fax_number": "843-552-0093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "283 DORCHESTER MANOR BLVD",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294208108",
            "telephone_number": "843-552-8000",
            "fax_number": "843-552-0093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUATTLEBAUM CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-17",
        "last_updated": "2010-08-12",
        "status": "A",
        "authorized_official_last_name": "QUATTLEBAUM",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-552-8000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "SC",
            "license": "3095",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "SC",
            "license": "3095",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CH3095",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Sports Physician Chiropractor in North Charleston, SC
• Providers in North Charleston, SC by specialty
• Sports Physician Chiropractor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2010; 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.