Individual provider Active NPI

Brent Allen Carraway, DC

  • Chiropractor
  • Sumter, SC
National Provider Identifier
1265322499
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5219 Issued in SC
Practice address
711 Bultman Dr
Sumter, SC 29150-2516
Phone
(803) 773-3421
NPI assigned
Jul 8, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5219 SC Primary

Addresses

Primary practice location

711 Bultman Dr
Sumter, SC 29150-2516

Mailing address

711 Bultman Dr
Sumter, SC 29150-2516
Phone (803) 773-3421

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250804000006 SC Practitioner - Chiropractic 7719495589 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Health and Injury ClinicGroup PAC ID 4486688504, 3 clinicians

Practice addresses (Care Compare)

711 Bultman Dr
Sumter, SC 29150-2516
Phone (803) 773-3421

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5219SCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Health & Injury Clinic Chiropractor CurrentSince May 12, 2025 Accepting new patients

Locations

608 S Mill St
Manning, SC 29102
Phone (803) 435-4050

711 Bultman Dr
Sumter, SC 29150
Phone (803) 773-3421

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": "1751932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1265322499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 BULTMAN DR",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291502516",
            "telephone_number": "803-773-3421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 BULTMAN DR",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291502516",
            "telephone_number": "803-773-3421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRAWAY",
        "first_name": "BRENT",
        "middle_name": "ALLEN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-08",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "5219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sumter, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.