Individual provider Active NPI

Anthony Paul Deangelo, D.C.

  • Chiropractor
  • Surfside Beach, SC
National Provider Identifier
1386844793
Registry record updated Jul 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3280 Issued in SC
Practice address
400 Highway 17 N
Surfside Beach, SC 29575-6029
Phone
(843) 238-5900
Fax
(843) 238-5910
NPI assigned
Jul 23, 2007
Last updated
Jul 10, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3280 SC Primary

Addresses

Primary practice location

400 Highway 17 N
Surfside Beach, SC 29575-6029

Mailing address

400 Highway 17 N
Surfside Beach, SC 29575-6029
Phone (843) 238-5900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081028000064 SC Practitioner - Chiropractic 8123186665 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

640 Morse Ave
Unit 1
Murrells Inlet, SC 29576-5116
Phone (843) 651-8787

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3280SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Deangelo Chiropractic Inc Chiropractor CurrentSince Oct 19, 2012 Accepting new patients

Locations

640 Morse Ave
Unit 1
Murrells Inlt, SC 29576
Phone (843) 651-8787

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215648000000",
    "number": "1386844793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 HIGHWAY 17 N",
            "city": "SURFSIDE BEACH",
            "state": "SC",
            "postal_code": "295756029",
            "telephone_number": "843-238-5900",
            "fax_number": "843-238-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HIGHWAY 17 N",
            "city": "SURFSIDE BEACH",
            "state": "SC",
            "postal_code": "295756029",
            "telephone_number": "843-238-5900",
            "fax_number": "843-238-5910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEANGELO",
        "first_name": "ANTHONY",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-23",
        "last_updated": "2008-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "3280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Surfside Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; 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.