Individual provider Active NPI

Deborah M Nodrick, DC

  • Chiropractor
  • Dillon, SC
National Provider Identifier
1437220944
Registry record updated Apr 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2219 Issued in SC
Practice address
500 E Jackson St
Dillon, SC 29536-2935
Phone
(843) 841-3911
Fax
(843) 841-3912
NPI assigned
Nov 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2219 SC Primary
Chiropractor 111N00000X 2615 NC

Addresses

Primary practice location

500 E Jackson St
Dillon, SC 29536-2935

Mailing address

500 E Jackson St
Dillon, SC 29536-2935
Phone (843) 841-3911

Other identifiers 1

IdentifierTypeStateIssuer
11656195OtherSCUNIVERSAL CREDENTIALING

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070213000478 SC Practitioner - Chiropractic 4789686288 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

200 W Harrison St
Suite C
Dillon, SC 29536-3331
Phone (843) 841-3911

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2615NCMDPsychologist
2219SCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Nodrick Chiropractic and Rehabilitation Center LLC Chiropractor CurrentSince Jan 19, 2007 Accepting new patients

Locations

200 W Harrison St
Ste C
Dillon, SC 29536
Phone (843) 841-3911

500 E Jackson St
Dillon, SC 29536
Phone (843) 774-2320

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303084800000",
    "number": "1437220944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 E JACKSON ST",
            "city": "DILLON",
            "state": "SC",
            "postal_code": "295362935",
            "telephone_number": "843-841-3911",
            "fax_number": "843-841-3912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E JACKSON ST",
            "city": "DILLON",
            "state": "SC",
            "postal_code": "295362935",
            "telephone_number": "843-841-3911",
            "fax_number": "843-841-3912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NODRICK",
        "first_name": "DEBORAH",
        "middle_name": "M",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2011-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "2219",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2615",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERSAL CREDENTIALING",
            "identifier": "11656195",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dillon, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2011; 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.