Donivol Tarrell Blue, D.C.

Primary specialty

Thermography ChiropractorTaxonomy code 111NT0100X

License

4120 Issued in SC

Practice address

1311 13TH Ave Unit C
Conway, SC 29526-3668

Phone

(843) 369-1831

Fax

(843) 369-1832

NPI assigned

Mar 6, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

ChiropracticAlso: Pain Management

Education

Life Chiropractic College, 2011

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1330992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1275807471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 13TH AVE UNIT C",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295263668",
            "telephone_number": "843-369-1831",
            "fax_number": "843-369-1832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 13TH AVE UNIT C",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295263668",
            "telephone_number": "843-369-1831",
            "fax_number": "843-369-1832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUE",
        "first_name": "DONIVOL",
        "middle_name": "TARRELL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-06",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NT0100X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Thermography",
            "state": "SC",
            "license": "4120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• BKD Conway SC LLC
• Elisabeth Blackwell
• Jamond Blake
• Kayla Moody Blanton
• Emily Blewitt, MSW
• Bluebird Healthcare, Inc.
• Russell Allen Boatwright Sr., D.M.D.
• Elizabeth S Boggs-Newbigging, MSW
• Richard H Bond, DMD
• Peter C Bondy, M.D.

• Chiropractor in Conway, SC
• Providers in Conway, SC by specialty
• Chiropractor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.