Individual provider Active NPI

Brent Scott Tobin, D.C.

  • Chiropractor
  • Irmo, SC
National Provider Identifier
1164862173
Registry record updated Jul 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3841 Issued in SC
Practice address
1032A Kinley Rd
Irmo, SC 29063-9632
Phone
(803) 732-6635
NPI assigned
Jul 5, 2013
Last updated
Jul 5, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3841 SC Primary

Addresses

Primary practice location

1032A Kinley Rd
Irmo, SC 29063-9632

Mailing address

110 Lake Hilton Dr
Chapin, SC 29036-7521
Phone (352) 978-0250

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140610001374 NC Practitioner - Chiropractic 4981828126 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3721 Lynn Rd
Suite 116
Raleigh, NC 27613-3855
Phone (919) 782-2014

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3841SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tobin Family Chiropractic Chiropractor CurrentSince Mar 16, 2014 Accepting new patients
Unified Family Health Center LLC PastSince Jan 12, 2020 Accepting new patients
Irmo Family Chiropractic, Inc Chiropractor Past Accepting new patients

Locations

3721 Lynn Rd
Ste 116
Raleigh, NC 27613
Phone (352) 978-0250

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1372982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372982400000",
    "number": "1164862173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 LAKE HILTON DR",
            "city": "CHAPIN",
            "state": "SC",
            "postal_code": "290367521",
            "telephone_number": "352-978-0250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1032A KINLEY RD",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290639632",
            "telephone_number": "803-732-6635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOBIN",
        "first_name": "BRENT",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-05",
        "last_updated": "2013-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "3841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irmo, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.