NPIMap

Organization Active NPI

Healthsource of Greenville-South

  • Chiropractor
  • Greenville, SC
National Provider Identifier
1235407560
Registry record updated Mar 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3562 Issued in SC
Legal business name
HEALTHSOURCE OF GREENVILLE-SOUTH
Practice address
104 Mauldin Rd
Suite G
Greenville, SC 29605-1221
Phone
(864) 272-0132
NPI assigned
Dec 1, 2011
Last updated
Mar 29, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2012

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

Authorized official

Name
Dr. Frederic Roedel McCain Jr., D.C.
Title
Owner
Phone
(864) 325-6373

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3562 SC Primary

Addresses

Primary practice location

104 Mauldin Rd
Suite G
Greenville, SC 29605-1221

Mailing address

104 Mauldin Rd
Suite G
Greenville, SC 29605-1221
Phone (864) 272-0132

National Provider Directory

National Provider Directory

Locations

104 Mauldin Rd
Ste G
Greenville, SC 29605
Phone (864) 272-0132

Practitioners & affiliated clinicians

Practitioners 3

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": "1322697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332979200000",
    "number": "1235407560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 MAULDIN RD",
            "address_2": "SUITE G",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296051221",
            "telephone_number": "864-272-0132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 MAULDIN RD",
            "address_2": "SUITE G",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296051221",
            "telephone_number": "864-272-0132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSOURCE OF GREENVILLE-SOUTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-01",
        "last_updated": "2012-03-29",
        "status": "A",
        "authorized_official_last_name": "MCCAIN",
        "authorized_official_first_name": "FREDERIC",
        "authorized_official_middle_name": "ROEDEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "864-325-6373",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "3562",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Mar 29, 2012; 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.