Organization Active NPI

Samuel Chiropractic PA

  • Chiropractor
  • Columbia, SC
National Provider Identifier
1407935596
Registry record updated Feb 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
SAMUEL CHIROPRACTIC PA
Practice address
2757 Laurel St
Suite 4
Columbia, SC 29204-2037
Phone
(803) 252-4966
Fax
(803) 252-1984
NPI assigned
Nov 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2020

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

Authorized official

Name
Dr. Virginia K Samuel, DC,CCEP,DABCI,BS,MS,
Title
Chiropractor, OT
Phone
(803) 252-4966

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

2757 Laurel St
Suite 4
Columbia, SC 29204-2037

Mailing address

2757 Laurel St
Suite 4
Columbia, SC 29204-2037
Phone (803) 252-4966

Other identifiers 1

IdentifierTypeStateIssuer
CH1561MedicaidSC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580860800000",
    "number": "1407935596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2757 LAUREL ST",
            "address_2": "SUITE 4",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042037",
            "telephone_number": "803-252-4966",
            "fax_number": "803-252-1984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2757 LAUREL ST",
            "address_2": "SUITE 4",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042037",
            "telephone_number": "803-252-4966",
            "fax_number": "803-252-1984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL CHIROPRACTIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A",
        "authorized_official_last_name": "SAMUEL",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CHIROPRACTOR, OT",
        "authorized_official_telephone_number": "803-252-4966",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC,CCEP,DABCI,BS,MS,"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CH1561",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2020; 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.