Individual provider Active NPI

Andrew Joseph Kasic, D.C.

  • Chiropractor
  • Rock Hill, SC
National Provider Identifier
1194728386
Registry record updated Oct 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2504 Issued in SC
Practice address
1430 Ebenezer Rd
Suite 101
Rock Hill, SC 29732
Phone
(803) 366-8600
Fax
(803) 366-8877
NPI assigned
May 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2504 SC Primary

Addresses

Primary practice location

1430 Ebenezer Rd
Suite 101
Rock Hill, SC 29732

Mailing address

1430 Ebenezer Rd
Ste 101
Rock Hill, SC 29732
Phone (803) 366-8600

Other identifiers 1

IdentifierTypeStateIssuer
CH2504MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051229000025 SC Practitioner - Chiropractic 0941222475 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1430 Ebenezer Rd
Suite 101
Rock Hill, SC 29732-2773
Phone (803) 366-8600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2504SCMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Care Clinic, Inc Chiropractor CurrentSince Apr 4, 2005 Accepting new patients
Wang'S Acupuncture & Herbal Clinic PastSince Apr 4, 2005 Accepting new patients

Locations

1430 Ebenezer Rd
Ste 101
Rock Hill, SC 29732
Phone (803) 366-8600

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286409600000",
    "number": "1194728386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 EBENEZER RD",
            "address_2": "STE 101",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "29732",
            "telephone_number": "803-366-8600",
            "fax_number": "803-366-8877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 EBENEZER RD",
            "address_2": "SUITE 101",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "29732",
            "telephone_number": "803-366-8600",
            "fax_number": "803-366-8877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASIC",
        "first_name": "ANDREW",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2010-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "2504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CH2504",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2010; 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.