Yaden Physical and Integrated Medical-LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

YADEN PHYSICAL AND INTEGRATED MEDICAL-LLC

Practice address

425 Barony St
Moncks Corner, SC 29461-3128

Phone

(843) 899-7933

Fax

(843) 899-5796

NPI assigned

Jul 1, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Jerald G Yaden, DCNPI 1033171038

Title

Owner

Phone

(843) 899-7933

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Practitioners 4

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

• Jerald G Yaden, DC

  • Chiropractor
  • Moncks Corner, SC
  • NPI 1033171038
  Medicare reassignment Authorized official
• Natalie Hendrickson, A-GNP

  • Nurse Practitioner
  • Moncks Corner, SC
  • NPI 1427661834

  Multi-Specialty

  Medicare reassignment NPD
• Michael Rosolino Mendola, D.O.

  • Emergency Medicine Physician
  • Bethpage, NY
  • NPI 1063618700

  SC

  Medicare reassignment NPD
• Megan Scarlet Quinn, FNP-C

  • Family Nurse Practitioner
  • Charleston, SC
  • NPI 1376106989
  NPD (past)

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

{
    "created_epoch": "1593561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724716800000",
    "number": "1255958658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 BARONY ST",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294613128",
            "telephone_number": "843-899-7933",
            "fax_number": "843-899-5796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 BARONY ST",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294613128",
            "telephone_number": "843-899-7933",
            "fax_number": "843-899-5796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YADEN PHYSICAL AND INTEGRATED MEDICAL-LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-01",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A",
        "authorized_official_last_name": "YADEN",
        "authorized_official_first_name": "JERALD",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-899-7933",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey Jeanne Woodruff, M.S.
• Samuel Worthen
• Isaac Wright Jr.
• Robyn Wyatt
• Yaden Chiropractic Inc.
• Jerald G Yaden, DC
• Lynn Yaden, PT
• Kim T Yoo
• Angela D Young
• Angelica Tashay Young, DNP-C

• Family Medicine Physician in Moncks Corner, SC
• Providers in Moncks Corner, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; 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.