Individual provider Active NPI

Jessica A Cardinal, DC

  • Chiropractor
  • Columbia, SC
National Provider Identifier
1164489332
Registry record updated Mar 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2340 Issued in SC
Practice address
7522 Irmo Dr
Ste 1
Columbia, SC 29212-8640
Phone
(803) 454-1096
Fax
(803) 454-1095
NPI assigned
Apr 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2340 SC Primary

Addresses

Primary practice location

7522 Irmo Dr
Ste 1
Columbia, SC 29212-8640

Mailing address

PO Box 1322
Irmo, SC 29063-1322
Phone (803) 454-1096

Other identifiers 1

IdentifierTypeStateIssuer
1649358508OtherSCGROUP NPI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040415000040 SC Practitioner - Chiropractic 0042204463 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2340SCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cardinal Chiropractic Inc Chiropractor CurrentSince Apr 1, 2004 Accepting new patients

Locations

401 Harbison Blvd
Ste 3
Columbia, SC 29212
Phone (803) 454-1096

7522 Irmo Dr
Ste 1
Columbia, SC 29212
Phone (803) 454-1096

1 Wellness Blvd
Ste 204
Irmo, SC 29063
Phone (803) 331-3682

601 Northwood Rd
Ste A
Lexington, SC 29072
Phone (516) 746-3135

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.

NPI Registry JSON

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

{
    "created_epoch": "1146268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521158400000",
    "number": "1164489332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1322",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290631322",
            "telephone_number": "803-454-1096",
            "fax_number": "803-454-1095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7522 IRMO DR",
            "address_2": "STE 1",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292128640",
            "telephone_number": "803-454-1096",
            "fax_number": "803-454-1095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDINAL",
        "first_name": "JESSICA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-29",
        "last_updated": "2018-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "2340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1649358508",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2018; 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.