Organization Active NPI

Life Chiropractic Center

  • Chiropractor
  • Charleston, SC
National Provider Identifier
1336265651
Registry record updated Mar 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1503 Issued in SC
Legal business name
LIFE CHIROPRACTIC CENTER
Practice address
1291 Folly Rd Ste M
Charleston, SC 29412-4115
Phone
(843) 795-5060
Fax
(843) 795-4870
NPI assigned
Mar 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2009

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

Authorized official

Name
Dr. Leonard James McGill, D.C.NPI 1932292802
Title
Owner
Phone
(843) 795-5060

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 1503 SC Primary

Addresses

Primary practice location

1291 Folly Rd Ste M
Charleston, SC 29412-4115

Mailing address

1291 Folly Rd Ste M
Charleston, SC 29412-4115
Phone (843) 795-5060

Other identifiers 1

IdentifierTypeStateIssuer
CH1503MedicaidSC

National Provider Directory

National Provider Directory

Locations

1291 Folly Rd
Ste M
Charleston, SC 29412
Phone (270) 834-8922

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237420800000",
    "number": "1336265651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1291 FOLLY RD STE M",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294124115",
            "telephone_number": "843-795-5060",
            "fax_number": "843-795-4870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1291 FOLLY RD STE M",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294124115",
            "telephone_number": "843-795-5060",
            "fax_number": "843-795-4870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE CHIROPRACTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2009-03-19",
        "status": "A",
        "authorized_official_last_name": "MCGILL",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-795-5060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "1503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CH1503",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2009; 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.