Chiropractic Lifestyles, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4032 DC Issued in SC

Legal business name

CHIROPRACTIC LIFESTYLES, LLC

Practice address

1810 Airport Blvd
Cayce, SC 29033-1807

Phone

(803) 796-3750

Fax

(803) 796-5202

NPI assigned

May 7, 2015

Organization subpart

No

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

Authorized official

Name

Jonathan M Gardner, DCNPI 1487032603

Title

Owner

Phone

(803) 796-3750

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 1

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

• Jonathan Gardner, DC

  • Chiropractor
  • Cayce, SC
  • NPI 1487032603
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1430956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695168000000",
    "number": "1235517525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 AIRPORT BLVD",
            "city": "CAYCE",
            "state": "SC",
            "postal_code": "290331807",
            "telephone_number": "803-796-3750",
            "fax_number": "803-796-5202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 AIRPORT BLVD",
            "city": "CAYCE",
            "state": "SC",
            "postal_code": "290331807",
            "telephone_number": "803-796-3750",
            "fax_number": "803-796-5202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC LIFESTYLES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-07",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-796-3750",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "4032 DC",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cayce Family Dentistry, LLC
• Charles E Millwood Jr DMD, PA
• Rosario Chedebeaux
• Thavi Cathy Chhoun, PT
• Adonelle Ropha Childs
• Congaree Home Medical, Inc.
• James Pate Cooper III, CHIROPRACTOR
• Roman B Cooper, D.C.
• Core Power Rehabilitation
• James Stewart Courtney, LPC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; 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.