NPIMap

Organization Active NPI

Evergreen Wellness, LLC

  • Chiropractor
  • Mauldin, SC
National Provider Identifier
1225315633
Registry record updated Dec 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3675 Issued in SC
Legal business name
EVERGREEN WELLNESS, LLC
Practice address
14 E Butler Rd Ste C
Mauldin, SC 29662-2402
Phone
(864) 297-6270
Fax
(864) 509-9378
NPI assigned
Nov 14, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2015

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

Authorized official

Name
Dr. Jerry D Nashman, DC
Title
Owner
Phone
(864) 297-6270

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 3675 SC Primary

Addresses

Primary practice location

14 E Butler Rd Ste C
Mauldin, SC 29662-2402

Mailing address

14 E Butler Rd Ste C
Mauldin, SC 29662-2402
Phone (864) 297-6270

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1321228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451433600000",
    "number": "1225315633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 E BUTLER RD STE C",
            "city": "MAULDIN",
            "state": "SC",
            "postal_code": "296622402",
            "telephone_number": "864-297-6270",
            "fax_number": "864-509-9378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 E BUTLER RD STE C",
            "city": "MAULDIN",
            "state": "SC",
            "postal_code": "296622402",
            "telephone_number": "864-297-6270",
            "fax_number": "864-509-9378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-14",
        "last_updated": "2015-12-30",
        "status": "A",
        "authorized_official_last_name": "NASHMAN",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "864-297-6270",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "3675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mauldin, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2015; 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.