Active NPI
Judson Lane Heldreth, D.C.
- Neurology Chiropractor
- Lexington, SC
National Provider Identifier
1255309068
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Chiropractor
- License
- 2254
- Practice address
- 929 N Lake Dr
Lexington, SC 29072-2137 - Phone
- (803) 356-8554
- Fax
- (803) 356-8245
- NPI assigned
- Mar 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Chiropractor | 111NN0400X | 2254 | SC | Primary |
Addresses
Primary practice location
929 N Lake Dr
Lexington, SC 29072-2137
Mailing address
929 N Lake Dr
Lexington, SC 29072-2137
Phone (803) 356-8554
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CH2254 | Medicaid | SC |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2254 | SC | MD | Neurology Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Palmetto Chiropractic Center Inc | Neurology | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322006400000",
"number": "1255309068",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "929 N LAKE DR",
"city": "LEXINGTON",
"state": "SC",
"postal_code": "290722137",
"telephone_number": "803-356-8554",
"fax_number": "803-356-8245"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "929 N LAKE DR",
"city": "LEXINGTON",
"state": "SC",
"postal_code": "290722137",
"telephone_number": "803-356-8554",
"fax_number": "803-356-8245"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HELDRETH",
"first_name": "JUDSON",
"middle_name": "LANE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-08",
"last_updated": "2011-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "111NN0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Neurology",
"state": "SC",
"license": "2254",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "CH2254",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lexington, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.