NPIMap

Organization Active NPI

Island Breeze Chiropractic Inc

  • Chiropractor
  • Pawleys Island, SC
National Provider Identifier
1427239698
Registry record updated Apr 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2786 Issued in SC
Legal business name
ISLAND BREEZE CHIROPRACTIC INC
Practice address
17C Professional LN
Pawleys Island, SC 29585-7988
Phone
(843) 314-3474
Fax
(843) 314-3475
NPI assigned
Nov 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2013

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

Authorized official

Name
Dr. Alan Walter Thompson, DCNPI 1770669822
Title
Owner
Phone
(843) 314-3474

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2786 SC Primary

Addresses

Primary practice location

17C Professional LN
Pawleys Island, SC 29585-7988

Mailing address

17C Professional LN
PO Box 1590
Pawleys Island, SC 29585-7988
Phone (843) 314-3474

Other identifiers 1

IdentifierTypeStateIssuer
CH 2786MedicaidSC

National Provider Directory

National Provider Directory

Locations

17 Professional Ln
Unit C
Pawleys Island, SC 29585
Phone (843) 235-8500

Practitioners 7

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": "1195171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366070400000",
    "number": "1427239698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17C PROFESSIONAL LN",
            "address_2": "PO BOX 1590",
            "city": "PAWLEYS ISLAND",
            "state": "SC",
            "postal_code": "295857988",
            "telephone_number": "843-314-3474",
            "fax_number": "843-314-3475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17C PROFESSIONAL LN",
            "city": "PAWLEYS ISLAND",
            "state": "SC",
            "postal_code": "295857988",
            "telephone_number": "843-314-3474",
            "fax_number": "843-314-3475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND BREEZE CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-16",
        "last_updated": "2013-04-16",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "WALTER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-314-3474",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "2786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CH 2786",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawleys Island, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2013; 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.