Providence Chiropractic, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

PROVIDENCE CHIROPRACTIC, LLC

Practice address

3071 Highway 21 Byp
Suite 103
Fort Mill, SC 29715-7205

Phone

(803) 835-0444

Fax

(803) 835-0489

NPI assigned

Mar 12, 2013

Last updated

Mar 12, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jessica M Harden, DC

Title

Provider

Phone

(803) 835-0444

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 2

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.

• Jessica Harden-Venable, D.C.

  • Chiropractor
  • Fort Mill, SC
  • NPI 1922354034
  Medicare reassignment NPD
• Joshua Scott Sullivan, DC

  • Chiropractor
  • Fort Mill, SC
  • NPI 1437080371
  NPD

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

{
    "created_epoch": "1363046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363046400000",
    "number": "1245571561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3071 HIGHWAY 21 BYP",
            "address_2": "SUITE 103",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297157205",
            "telephone_number": "803-835-0444",
            "fax_number": "803-835-0489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3071 HIGHWAY 21 BYP",
            "address_2": "SUITE 103",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297157205",
            "telephone_number": "803-835-0444",
            "fax_number": "803-835-0489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-12",
        "last_updated": "2013-03-12",
        "status": "A",
        "authorized_official_last_name": "HARDEN",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "803-835-0444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Fort Mill, SC
• Providers in Fort Mill, SC by specialty
• Chiropractor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2013; 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.