Individual provider Active NPI

Gina Lynn Courson, B.S,D.C

  • Chiropractor
  • Mt Pleasant, SC
National Provider Identifier
1366484073
Registry record updated Apr 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2532 Issued in SC
Practice address
3373 S Morgans Point Rd
Suite 307
Mt Pleasant, SC 29466-8331
Phone
(843) 971-8814
Fax
(843) 971-1933
NPI assigned
Jun 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 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 2532 SC Primary

Addresses

Primary practice location

3373 S Morgans Point Rd
Suite 307
Mt Pleasant, SC 29466-8331

Mailing address

3373 S Morgans Point Rd
Suite 307
Mt Pleasant, SC 29466-8331
Phone (843) 971-8814

Other identifiers 1

IdentifierTypeStateIssuer
CH2532MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041012001500 SC Practitioner - Chiropractic 5597725796

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333411200000",
    "number": "1366484073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3373 S MORGANS POINT RD",
            "address_2": "SUITE 307",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294668331",
            "telephone_number": "843-971-8814",
            "fax_number": "843-971-1933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3373 S MORGANS POINT RD",
            "address_2": "SUITE 307",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294668331",
            "telephone_number": "843-971-8814",
            "fax_number": "843-971-1933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COURSON",
        "first_name": "GINA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "B.S,D.C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-10",
        "last_updated": "2012-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "2532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CH2532",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2012; 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.