Organization Active NPI

Advanced Wellness Center

  • Chiropractor
  • Hartsville, SC
National Provider Identifier
1316094378
Registry record updated Mar 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
ADVANCED WELLNESS CENTER
Practice address
107 Armory St
Hartsville, SC 29550-5421
Phone
(843) 332-4672
Fax
(843) 332-0798
NPI assigned
Jan 4, 2007
Last updated
Mar 12, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2010

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

Authorized official

Name
Ms. Lynn Morris
Title
Practice Manager
Phone
(843) 332-4672

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

107 Armory St
Hartsville, SC 29550-5421

Mailing address

107 Armory St
Hartsville, SC 29550-5421
Phone (843) 332-4672

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100528000261 SC Part B Supplier - Clinic/Group Practice 7012046121 Receives reassigned benefits from 1 practitioner
Practice locations: Hartsville, SC

National Provider Directory

National Provider Directory

Locations

541 W Carolina Ave
Hartsville, SC 29550
Phone (843) 332-4672

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268352000000",
    "number": "1316094378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 ARMORY ST",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295505421",
            "telephone_number": "843-332-4672",
            "fax_number": "843-332-0798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 ARMORY ST",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295505421",
            "telephone_number": "843-332-4672",
            "fax_number": "843-332-0798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2010-03-12",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "843-332-4672",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartsville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2010; 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.