Elite Performance and Pain Center LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3131 Issued in SC

Legal business name

ELITE PERFORMANCE AND PAIN CENTER LLC

Practice address

761 Saint Andrews Blvd
Charleston, SC 29407-7164

Phone

(843) 873-6004

NPI assigned

Jan 24, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jeremiah Jason Jimerson, D.C.NPI 1558302869

Title

President

Phone

(843) 873-6004

Specialties & licenses 1

Addresses

Other names 1

• Active Care Family Chiropractic LLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 4

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

• Jeremiah J. Jimerson, D.C.

  • Chiropractor
  • Charleston, SC
  • NPI 1558302869
  Medicare reassignment Authorized official
• Bianca Marie Iberle, DC

  • Chiropractor
  • Summerville, SC
  • NPI 1063170975
  NPD (past)
• Tiffany Crystal Milroy

  • Massage Therapist
  • Summerville, SC
  • NPI 1548518855
  NPD (past)
• Zachary W Stoller, D.C.

  • Chiropractor
  • Columbus, OH
  • NPI 1033591664
  NPD (past)

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617062400000",
    "number": "1225183783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "761 ST. ANDREWS BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29407",
            "telephone_number": "843-873-6004",
            "fax_number": "843-766-3694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "761 SAINT ANDREWS BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294077164",
            "telephone_number": "843-873-6004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE PERFORMANCE AND PAIN CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A",
        "authorized_official_last_name": "JIMERSON",
        "authorized_official_first_name": "JEREMIAH",
        "authorized_official_middle_name": "JASON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-873-6004",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "3131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Active Care Family Chiropractic LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Puja Sukhwani Elias, M.D.
• Rene A. Elias, MD
• Pamela Lynn Eliason, APRN-BC
• Robert T. Eliason, CRNA
• Elite Family Chiropractic LLC
• Elite Performance Concepts, LLC
• Elizabeth J. Dixon, LLC
• Jennifer L Elkins, BCBA
• Chloe Denae Elledge
• Jonathan Ellement, M.D.

• Chiropractor in Charleston, SC
• Providers in Charleston, SC by specialty
• Chiropractor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.