Individual provider Active NPI

Robert Lewis Pascal, D.C.

  • Chiropractor
  • Moncks Corner, SC
National Provider Identifier
1164587960
Registry record updated Apr 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1805 Issued in SC
Practice address
202 Carolina Ave
Moncks Corner, SC 29461-3785
Phone
(843) 899-9088
Fax
(843) 899-9088
NPI assigned
Dec 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1805 SC Primary

Addresses

Primary practice location

202 Carolina Ave
Moncks Corner, SC 29461-3785

Mailing address

1182 Waterfront Dr
Mount Pleasant, SC 29464-7427
Phone (843) 364-9879

Other identifiers 1

IdentifierTypeStateIssuer
CH1805MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Chiropractic Chiropractor Past Accepting new patients
Trips Chiropractic Chiropractor Past Accepting new patients
Berry Massagetherapy & Chiropractic Center Chiropractor Past Accepting new patients
Gray'S Pain Relief Center, LLC PastSince Feb 5, 2014 Accepting new patients

Organizations & group practices 4

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": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239235200000",
    "number": "1164587960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1182 WATERFRONT DR",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294647427",
            "telephone_number": "843-364-9879",
            "fax_number": "843-722-4845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 CAROLINA AVE",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294613785",
            "telephone_number": "843-899-9088",
            "fax_number": "843-899-9088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASCAL",
        "first_name": "ROBERT",
        "middle_name": "LEWIS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-22",
        "last_updated": "2009-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "1805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CH1805",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moncks Corner, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2009; 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.