NPIMap

Organization Active NPI

Waccamaw Family Chiropractic, P.C.

  • Chiropractor
  • Murrells Inlet, SC
National Provider Identifier
1215162136
Registry record updated Nov 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3457 Issued in SC
Legal business name
WACCAMAW FAMILY CHIROPRACTIC, P.C.
Practice address
11945 Grandhaven Dr
Suite F
Murrells Inlet, SC 29576-8091
Phone
(843) 357-7200
Fax
(843) 357-7203
NPI assigned
May 20, 2009
Last updated
Nov 25, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2014

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

Authorized official

Name
Dr. Matthew R. Cullum, D.C.NPI 1588808794
Title
President
Phone
(803) 240-8766

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 3457 SC Primary

Addresses

Primary practice location

11945 Grandhaven Dr
Suite F
Murrells Inlet, SC 29576-8091

Mailing address

11945 Grandhaven Dr
Suite F
Murrells Inlet, SC 29576-8091
Phone (843) 357-7200

Other names 1

  • Triune of Life Chiropratic, P.C. Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1242777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416873600000",
    "number": "1215162136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11945 GRANDHAVEN DR",
            "address_2": "SUITE F",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295768091",
            "telephone_number": "843-357-7200",
            "fax_number": "843-357-7203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11945 GRANDHAVEN DR",
            "address_2": "SUITE F",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295768091",
            "telephone_number": "843-357-7200",
            "fax_number": "843-357-7203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WACCAMAW FAMILY CHIROPRACTIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-20",
        "last_updated": "2014-11-25",
        "status": "A",
        "authorized_official_last_name": "CULLUM",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "803-240-8766",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "3457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Triune of Life Chiropratic, P.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Murrells Inlet, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.