Individual provider Active NPI

Jonathan W Krause, DC

  • Chiropractor
  • Chapin, SC
National Provider Identifier
1174573141
Registry record updated Jan 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1078 Issued in SC
Practice address
510 Columbia Ave
Suite D
Chapin, SC 29036-9424
Phone
(803) 345-5462
NPI assigned
May 11, 2006
Last updated
Jan 31, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1078 SC Primary

Addresses

Primary practice location

510 Columbia Ave
Suite D
Chapin, SC 29036-9424

Mailing address

510 Columbia Avenue
Chapin, SC 29036-0895
Phone (803) 345-5462

Other identifiers 1

IdentifierTypeStateIssuer
CH1078MedicaidSC

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

State licenses

LicenseStateTypeSpecialty
1078SCMDDental Hygienist
2493ALMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Willis Chiro Med of Columbia, Inc. Chiropractor Past Accepting new patients

Organizations & group practices 2

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391126400000",
    "number": "1174573141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 COLUMBIA AVENUE",
            "city": "CHAPIN",
            "state": "SC",
            "postal_code": "290360895",
            "telephone_number": "803-345-5462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 COLUMBIA AVE",
            "address_2": "SUITE D",
            "city": "CHAPIN",
            "state": "SC",
            "postal_code": "290369424",
            "telephone_number": "803-345-5462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAUSE",
        "first_name": "JONATHAN",
        "middle_name": "W",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2014-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "1078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CH1078",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapin, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2014; 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.