Individual provider Active NPI

John William Gallagher, D.C.

  • Chiropractor
  • Walterboro, SC
National Provider Identifier
1306001128
Registry record updated Apr 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3375 Issued in SC
Practice address
211 Eddie Chasteen Dr
Walterboro, SC 29488
Phone
(843) 539-1111
NPI assigned
Jul 21, 2008
Last updated
Apr 29, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3375 SC Primary

Addresses

Primary practice location

211 Eddie Chasteen Dr
Walterboro, SC 29488

Mailing address

211 Eddie Chasteen Dr
Walterboro, SC 29488-5728
Phone (843) 539-1111

Other practice location 1

4510 Jefferies Hwy
Walterboro, SC 29488-6489
Phone (843) 539-1111

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081015000280 SC Practitioner - Chiropractic 5597830695 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2008
Medicare assignment
May accept Medicare assignment
Group practices
Colleton Chiropractic, LLCGroup PAC ID 0143395244, 3 clinicians

Practice addresses (Care Compare)

211 Eddie Chasteen Dr
Walterboro, SC 29488-5728
Phone (843) 539-1111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina West Clinic of Chiropractic LLC Chiropractor CurrentSince Sep 26, 2016 Accepting new patients
Central Georgia Clinic of Chiropractic LLC Chiropractor CurrentSince Apr 4, 2016 Accepting new patients
Colleton Chiropractic, LLC Chiropractor CurrentSince Mar 11, 2008 Accepting new patients

Locations

211 Eddie Chasteen Dr
Walterboro, SC 29488
Phone (843) 539-1111

4510 Jefferies Hwy
Walterboro, SC 29488
Phone (843) 539-1111

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556496000000",
    "number": "1306001128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 EDDIE CHASTEEN DR",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294885728",
            "telephone_number": "843-539-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 EDDIE CHASTEEN DR",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "29488",
            "telephone_number": "843-539-1111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4510 Jefferies Hwy",
            "address_purpose": "LOCATION",
            "city": "Walterboro",
            "state": "SC",
            "postal_code": "294886489",
            "country_code": "US",
            "telephone_number": "843-539-1111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALLAGHER",
        "first_name": "JOHN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-21",
        "last_updated": "2019-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "3375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walterboro, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2019; 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.