Individual provider Active NPI

Debbie Rose Dove-Kidd, DC

  • Chiropractor
  • Goose Creek, SC
National Provider Identifier
1235193830
Registry record updated Sep 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0773 Issued in SC
Practice address
105 Greenland Dr
Goose Creek, SC 29445-5354
Phone
(843) 797-3290
Fax
(843) 797-8598
NPI assigned
Apr 12, 2006
Last updated
Sep 27, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0773 SC Primary

Addresses

Primary practice location

105 Greenland Dr
Goose Creek, SC 29445-5354

Mailing address

PO Box 810
Goose Creek, SC 29445-0810
Phone (843) 797-3290

Other identifiers 2

IdentifierTypeStateIssuer
571112754OtherSCTAX ID #
CH0773MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0773SCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Intentional Wellness LLC Chiropractor PastSince Oct 5, 2021 Accepting new patients

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, 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": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380240000000",
    "number": "1235193830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 810",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294450810",
            "telephone_number": "843-797-3290",
            "fax_number": "843-797-8598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 GREENLAND DR",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294455354",
            "telephone_number": "843-797-3290",
            "fax_number": "843-797-8598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOVE-KIDD",
        "first_name": "DEBBIE",
        "middle_name": "ROSE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-12",
        "last_updated": "2013-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "0773",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "571112754",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CH0773",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goose Creek, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2013; 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.