Carolina Sports Clinic-Fort Mill,LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3905 Issued in SC

Legal business name

CAROLINA SPORTS CLINIC-FORT MILL,LLC

Practice address

985 Market St
Suite 201
Fort Mill, SC 29708-6532

Phone

(704) 449-6601

Fax

(980) 225-7914

NPI assigned

Jul 24, 2015

Last updated

Sep 28, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Bradley Weist

Title

Manager

Phone

(803) 547-9800

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 7

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.

• Jared A Sams, DC

  • Chiropractor
  • Fort Mill, SC
  • NPI 1770020075
  Medicare reassignment Care Compare group NPD
• Laura Elizabeth Sundquist, PT

  • Physical Therapist
  • Fort Mill, SC
  • NPI 1427305978
  Medicare reassignment Care Compare group NPD
• Courtenay Boyle, D.C.

  • Chiropractor
  • Charlotte, NC
  • NPI 1568856052

  SC

  Medicare reassignment Care Compare group NPD
• Theresa Lobbestael, DC

  • Chiropractor
  • Fort Mill, SC
  • NPI 1003235854
  Medicare reassignment NPD
• Joshua Kollman, D.C.

  • Chiropractor
  • Charlotte, NC
  • NPI 1245379445

  SC

  Medicare reassignment NPD
• Bradley David Wiest

  • Chiropractor
  • Charlotte, NC
  • NPI 1629395017

  SC

  Medicare reassignment NPD
• Zachary Luke Ratliff, DC, ATC

  • Chiropractor
  • Fort Mill, SC
  • NPI 1467015115
  NPD (past)

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

{
    "created_epoch": "1437696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443398400000",
    "number": "1144605759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "985 MARKET ST",
            "address_2": "SUITE 201",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297086532",
            "telephone_number": "803-547-9800",
            "fax_number": "803-547-9804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "985 MARKET ST",
            "address_2": "SUITE 201",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297086532",
            "telephone_number": "704-449-6601",
            "fax_number": "980-225-7914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA SPORTS CLINIC-FORT MILL,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-24",
        "last_updated": "2015-09-28",
        "status": "A",
        "authorized_official_last_name": "WEIST",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "803-547-9800",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "3905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolina Podiatry Group, Inc.
• Carolina Professional Dentistry,LLC
• Carolina Speech Connection, LLC
• Carolina Speech Works
• Carolina Speech Works, LLC
• Carolina Surgery Center LLC (Surgery Center at Edgewater CRNA Group)
• Carolina Surgery Center LLC (The Surgery Center at Edgewater)
• Carolina Surgery Vein Clinic LLC (Legacy Health and Wellness)
• Carolina Therapeutics, LLC
• Carolina Urology Center, PA

• Chiropractor in Fort Mill, SC
• Providers in Fort Mill, SC by specialty
• Chiropractor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2015; 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.