Wurst Chiropractic Center

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2276 Issued in SC

Legal business name

WURST CHIROPRACTIC CENTER

Doing business as

B.L. Black Clinic of Chiropractic

Practice address

1350 Chuck Dawley Blvd
Mt Pleasant, SC 29464-3380

Phone

(843) 884-3506

Fax

(843) 856-0912

NPI assigned

May 25, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Matthew R Wurst, D.C.

Title

Owner/Doctor

Phone

(843) 884-3506

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• B.L. Black Clinic of Chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 3

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

• Matt R Wurst, D.C.

  • Chiropractor
  • Mt Pleasant, SC
  • NPI 1801954235
  Medicare reassignment NPD
• Maggie Hall, LMT

  • Specialist
  • Mt Pleasant, SC
  • NPI 1962678060
  NPD (past)
• Kelly Williams, LMT

  • Specialist
  • Mt Pleasant, SC
  • NPI 1740456953
  NPD (past)

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

{
    "created_epoch": "1306281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306281600000",
    "number": "1255624136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 CHUCK DAWLEY BLVD",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294643380",
            "telephone_number": "843-884-3506",
            "fax_number": "843-856-0912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 CHUCK DAWLEY BLVD",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294643380",
            "telephone_number": "843-884-3506",
            "fax_number": "843-856-0912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WURST CHIROPRACTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-25",
        "last_updated": "2011-05-25",
        "status": "A",
        "authorized_official_last_name": "WURST",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "843-884-3506",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "2276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "U767900281",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "B.L. Black Clinic of Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lauren Wray
• Wright Bracing
• David K. Wright, M.D.
• Kimberly R Wright, FNP
• Robbie Wayne Wright
• Matt R Wurst, D.C.
• Jonsye D Wurthmann, LPC
• Joy H Wymer, PH.D.
• Melanie Wysong, PHARMD
• Sherif Zaghloul Yacoub, MD

• Chiropractor in Mt Pleasant, SC
• Providers in Mt Pleasant, SC by specialty
• Chiropractor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2011; 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.