NPIMap

Organization Active NPI

Dutch Fork Chiropractic Center PA

  • Chiropractor
  • Irmo, SC
National Provider Identifier
1174508170
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1953 Issued in SC
Legal business name
DUTCH FORK CHIROPRACTIC CENTER PA
Practice address
7839 Broad River Rd
Irmo, SC 29063-2357
Phone
(803) 732-3996
Fax
(803) 407-0081
NPI assigned
Dec 13, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Deborah Marie Milano, DC
Title
Chiropractor Owner
Phone
(803) 732-3996

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 1953 SC Primary

Addresses

Primary practice location

7839 Broad River Rd
Irmo, SC 29063-2357

Mailing address

7839 Broad River Rd
Irmo, SC 29063-2357
Phone (803) 732-3996

Other identifiers 1

IdentifierTypeStateIssuer
GCH432MedicaidSC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174508170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7839 BROAD RIVER RD",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290632357",
            "telephone_number": "803-732-3996",
            "fax_number": "803-407-0081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7839 BROAD RIVER RD",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290632357",
            "telephone_number": "803-732-3996",
            "fax_number": "803-407-0081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUTCH FORK CHIROPRACTIC CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MILANO",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CHIROPRACTOR OWNER",
        "authorized_official_telephone_number": "803-732-3996",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "1953",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GCH432",
            "state": "SC"
        }
    ],
    "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 Aug 22, 2020; 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.