Organization Active NPI

Lakelands Holding, LLC

Doing business as Lakelands Chiropractic

  • Chiropractor
  • Greenwood, SC
National Provider Identifier
1255569158
Registry record updated Sep 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1337 Issued in SC
Legal business name
LAKELANDS HOLDING, LLC
Doing business as
Lakelands Chiropractic
Practice address
712B Montague Ave
Greenwood, SC 29649-1439
Phone
(864) 223-2663
NPI assigned
Jun 30, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2009

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

Authorized official

Name
Dr. Charles H Weston Jr., DCNPI 1023182441
Title
President
Phone
(864) 223-2663

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 1337 SC Primary

Addresses

Primary practice location

712B Montague Ave
Greenwood, SC 29649-1439

Mailing address

712B Montague Ave
Greenwood, SC 29649-1439
Phone (864) 223-2663

Other identifiers 1

IdentifierTypeStateIssuer
CS 1337MedicaidSC

Other names 1

  • Lakelands Chiropractic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090914000336 SC Part B Supplier - Clinic/Group Practice 3779639919 Receives reassigned benefits from 1 practitioner
Practice locations: Greenwood, SC

National Provider Directory

National Provider Directory

Locations

712B Montague Ave
Greenwood, SC 29649
Phone (864) 223-2663

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252540800000",
    "number": "1255569158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712B MONTAGUE AVE",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296491439",
            "telephone_number": "864-223-2663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712B MONTAGUE AVE",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296491439",
            "telephone_number": "864-223-2663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKELANDS HOLDING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-30",
        "last_updated": "2009-09-10",
        "status": "A",
        "authorized_official_last_name": "WESTON",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-223-2663",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "1337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CS 1337",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakelands Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenwood, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2009; 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.