Form X Function Wellness, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

FORM X FUNCTION WELLNESS, LLC

Practice address

6 Sevier St
Greenville, SC 29605

Phone

(864) 214-6163

NPI assigned

Sep 16, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Joseph David Pelicano, DCNPI 1609607100

Title

Ceo

Phone

(864) 293-4213

Specialties & licenses 1

Addresses

Practitioners 1

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

• Joseph David Pelicano, DC

  • Chiropractor
  • Greenville, SC
  • NPI 1609607100
  NPD Authorized official

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

{
    "created_epoch": "1726444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726444800000",
    "number": "1356178271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 PEACH GROVE PL",
            "city": "MAULDIN",
            "state": "SC",
            "postal_code": "296623406",
            "telephone_number": "864-293-4213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 SEVIER ST",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "29605",
            "telephone_number": "864-214-6163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORM X FUNCTION WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-16",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-09",
        "status": "A",
        "authorized_official_last_name": "PELICANO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "864-293-4213",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Elizabeth Ford, APRN-FNP
• Cameron Fordham, BSN, RN
• Forensic Counseling Associates, Professional Corporation
• William Alexander Forgach II, D.O.
• Lisa Marie Forgione
• Shannon Forman, 4188
• Lisa Dandridge Forrester, MD
• Ryan Taylor Forrester, M.D.
• Simon Blaine Forrester, CRNA
• Carl Gunnar Forsberg, M.D.

• Chiropractor in Greenville, SC
• Providers in Greenville, SC by specialty
• Chiropractor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; 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.