Individual provider Active NPI

Jeff Eulau, D.C.

  • Chiropractor
  • Goose Creek, SC
National Provider Identifier
1316942279
Registry record updated Nov 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2419 Issued in SC
Practice address
119 Spring Hall Dr
Ste B
Goose Creek, SC 29445-5368
Phone
(843) 572-9090
Fax
(843) 572-7025
NPI assigned
Jun 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2419 SC Primary

Addresses

Primary practice location

119 Spring Hall Dr
Ste B
Goose Creek, SC 29445-5368

Mailing address

119 Spring Hall Dr
Ste B
Goose Creek, SC 29445-5368
Phone (843) 572-9090

Other identifiers 2

IdentifierTypeStateIssuer
GCH396MedicaidSC
CH2419MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090114000146 SC Practitioner - Chiropractic 3870656028 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

119 Springhall Dr
Suite B
Goose Creek, SC 29445-5368
Phone (843) 572-9090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2419SCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Crowfield Spine Center, P.a. Chiropractor CurrentSince Nov 16, 2008 Accepting new patients

Locations

119 Springhall Dr
Ste B
Goose Creek, SC 29445
Phone (843) 572-9090

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": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353024000000",
    "number": "1316942279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 SPRING HALL DR",
            "address_2": "STE B",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294455368",
            "telephone_number": "843-572-9090",
            "fax_number": "843-572-7025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 SPRING HALL DR",
            "address_2": "STE B",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294455368",
            "telephone_number": "843-572-9090",
            "fax_number": "843-572-7025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EULAU",
        "first_name": "JEFF",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2012-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "2419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GCH396",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CH2419",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goose Creek, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2012; 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.