Organization Active NPI

River Landing Chiropractic, Inc

  • Sports Physician Chiropractor
  • Charleston, SC
National Provider Identifier
1407039183
Registry record updated Apr 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
2653 Issued in SC
Legal business name
RIVER LANDING CHIROPRACTIC, INC
Practice address
130 River Landing Dr
12 D
Charleston, SC 29492-7440
Phone
(843) 971-8234
NPI assigned
Dec 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2008

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

Authorized official

Name
Jimmy Lee Smith Jr., D.C.NPI 1386731016
Title
President
Phone
(843) 971-8234

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
Sports Physician ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NS0005X 2653 SC Primary

Addresses

Primary practice location

130 River Landing Dr
12 D
Charleston, SC 29492-7440

Mailing address

130 River Landing Dr
12 D
Charleston, SC 29492-7440
Phone (843) 971-8234

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031218000286 SC Part B Supplier - Clinic/Group Practice 4082511803 Receives reassigned benefits from 3 practitioners
Practice locations: Daniel Island, SC

National Provider Directory

National Provider Directory

Locations

130 River Landing Dr
Unit 12D
Daniel Island, SC 29492
Phone (843) 527-4200

Practitioners & affiliated clinicians

Practitioners 3

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": "1197849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207699200000",
    "number": "1407039183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 RIVER LANDING DR",
            "address_2": "12 D",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294927440",
            "telephone_number": "843-971-8234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 RIVER LANDING DR",
            "address_2": "12 D",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294927440",
            "telephone_number": "843-971-8234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER LANDING CHIROPRACTIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-17",
        "last_updated": "2008-04-09",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JIMMY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-971-8234",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "SC",
            "license": "2653",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Apr 9, 2008; 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.