NPIMap

Organization Active NPI

Enhanced Living-Simpsonville Chiropractic, LLC

  • Chiropractor
  • Simpsonville, SC
National Provider Identifier
1346843489
Registry record updated Nov 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
ENHANCED LIVING-SIMPSONVILLE CHIROPRACTIC, LLC
Practice address
227 N Main St
Simpsonville, SC 29681-2310
Phone
(864) 848-0640
NPI assigned
Nov 20, 2020
Last updated
Nov 23, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2020

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

Authorized official

Name
Nina R Kennedy, DCNPI 1376790535
Title
Doctor
Phone
(864) 380-8804

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 Primary

Addresses

Primary practice location

227 N Main St
Simpsonville, SC 29681-2310

Mailing address

140 Sage Creek Way
Greer, SC 29650-0957
Phone (864) 848-0640

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210204000390 SC Part B Supplier - Clinic/Group Practice 1052725991 Receives reassigned benefits from 2 practitioners
Practice locations: Simpsonville, SC

National Provider Directory

National Provider Directory

Locations

140 Sage Creek Way
Greer, SC 29650
Phone (864) 846-0640

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606089600000",
    "number": "1346843489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 SAGE CREEK WAY",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296500957",
            "telephone_number": "864-848-0640",
            "fax_number": "864-848-0646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 N MAIN ST",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296812310",
            "telephone_number": "864-848-0640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENHANCED LIVING-SIMPSONVILLE CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-20",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "NINA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "864-380-8804",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simpsonville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; 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.