Individual provider Active NPI

Mickey Travis Sizemore, D.C.

  • Chiropractor
  • Greenville, SC
National Provider Identifier
1194885111
Registry record updated Oct 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR010432 Issued in GA
Practice address
4200 E North St
Suite 18
Greenville, SC 29615-2437
Phone
(864) 292-0226
Fax
(864) 268-7022
NPI assigned
Dec 11, 2006
Last updated
Oct 23, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CHIR010432 GA Primary
Chiropractor 111N00000X 3595 SC

Addresses

Primary practice location

4200 E North St
Suite 18
Greenville, SC 29615-2437

Mailing address

1241 Clingman Dr
Fort Mill, SC 29715-0083
Phone (843) 295-2998

Other identifiers 1

IdentifierTypeStateIssuer
385786OtherVAANTHEM BCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201030000797 GA Practitioner - Chiropractic 2860579372 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Zellweger Family ChiropracticGroup PAC ID 9234405044, 4 clinicians

Practice addresses (Care Compare)

461 Johnny Mercer Blvd
Suite C3
Savannah, GA 31410-2221
Phone (843) 706-2378

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3595SCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Chirowellness Chiropractor Current Accepting new patients
Mickey Travis Sizemore Chiropractor Past Accepting new patients
Healthsource Cayce, LLC Chiropractor Past Accepting new patients
Zellweger Family Chiropractic Chiropractor Past Accepting new patients

Locations

2427 Fish Hatchery Rd
West Columbia, SC 29172
Phone (803) 939-0785

Organizations & group practices 5

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": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1194885111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1241 CLINGMAN DR",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297150083",
            "telephone_number": "843-295-2998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 E NORTH ST",
            "address_2": "SUITE 18",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296152437",
            "telephone_number": "864-292-0226",
            "fax_number": "864-268-7022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIZEMORE",
        "first_name": "MICKEY",
        "middle_name": "TRAVIS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR010432",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "3595",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "385786",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2020; 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.