Individual provider Active NPI

Jon Keith Bergrin, DC

  • Chiropractor
  • Florence, SC
National Provider Identifier
1285608208
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1184 Issued in SC
Practice address
405 S Ebenezer Rd
Florence, SC 29501-7916
Phone
(843) 662-4341
Fax
(843) 679-3060
NPI assigned
Feb 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1184 SC Primary

Addresses

Primary practice location

405 S Ebenezer Rd
Florence, SC 29501-7916

Mailing address

405 S Ebenezer Rd
Florence, SC 29501-7916
Phone (843) 662-4341

Other identifiers 1

IdentifierTypeStateIssuer
CH1184MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
1184SCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Brian Colquitt SC DC PA Chiropractor CurrentSince May 21, 2023 Accepting new patients

Locations

405 S Ebenezer Rd
Florence, SC 29501
Phone (843) 662-4341

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": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1285608208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 S EBENEZER RD",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295017916",
            "telephone_number": "843-662-4341",
            "fax_number": "843-679-3060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 S EBENEZER RD",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295017916",
            "telephone_number": "843-662-4341",
            "fax_number": "843-679-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGRIN",
        "first_name": "JON",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "1184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CH1184",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.