Individual provider Active NPI

Timothy B O Neill, D.C.

  • Sports Physician Chiropractor
  • Myrtle Beach, SC
National Provider Identifier
1467521971
Registry record updated Jan 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
1029 Issued in SC
Practice address
3975 Dick Pond Rd
Myrtle Beach, SC 29588-6800
Phone
(843) 650-3232
Fax
(843) 650-9877
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 1029 SC Primary

Addresses

Primary practice location

3975 Dick Pond Rd
Myrtle Beach, SC 29588-6800

Mailing address

3975 Dick Pond Rd
Myrtle Beach, SC 29588-6800
Phone (843) 650-3232

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080409000285 SC Practitioner - Chiropractic 5395822738 Receives reassigned benefits from 1 practitioner
Practice locations: Myrtle Beach, SC

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 1985
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3975 Dick Pond Rd
Myrtle Beach, SC 29588-6800
Phone (843) 650-3232

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1029SCMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Timothy B. O'Neill, DC, PA Sports Physician CurrentSince Jan 1, 1990 Accepting new patients

Locations

3975 Dick Pond Rd
Myrtle Beach, SC 29588
Phone (843) 293-8007

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452556800000",
    "number": "1467521971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3975 DICK POND RD",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295886800",
            "telephone_number": "843-650-3232",
            "fax_number": "843-650-9877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3975 DICK POND RD",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295886800",
            "telephone_number": "843-650-3232",
            "fax_number": "843-650-9877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O NEILL",
        "first_name": "TIMOTHY",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2016-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "SC",
            "license": "1029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2016; 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.