NPIMap

Organization Active NPI

Lake Murray Pain and Rehab, LLC

  • Chiropractor
  • Chapin, SC
National Provider Identifier
1235573015
Registry record updated Apr 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
111N00000X Issued in SC
Legal business name
LAKE MURRAY PAIN AND REHAB, LLC
Practice address
510 Columbia Ave
Chapin, SC 29036-9424
Phone
(803) 345-0334
Fax
(803) 345-0335
NPI assigned
Apr 23, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2013

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

Authorized official

Name
Dr. William Edward Bull III, DC
Title
Owner
Phone
(803) 345-0334

Specialties & licenses 1

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

Addresses

Primary practice location

510 Columbia Ave
Chapin, SC 29036-9424

Mailing address

510 Columbia Ave
Chapin, SC 29036-9424
Phone (803) 345-0334

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1366675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366675200000",
    "number": "1235573015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 COLUMBIA AVE",
            "city": "CHAPIN",
            "state": "SC",
            "postal_code": "290369424",
            "telephone_number": "803-345-0334",
            "fax_number": "803-345-0335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 COLUMBIA AVE",
            "city": "CHAPIN",
            "state": "SC",
            "postal_code": "290369424",
            "telephone_number": "803-345-0334",
            "fax_number": "803-345-0335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE MURRAY PAIN AND REHAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-23",
        "last_updated": "2013-04-23",
        "status": "A",
        "authorized_official_last_name": "BULL",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-345-0334",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "111N00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapin, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.