Organization Active NPI

Palmetto Chiropractic Wellness Center LLC

  • Chiropractor
  • Orangeburg, SC
National Provider Identifier
1467626002
Registry record updated Sep 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2929 Issued in SC
Legal business name
PALMETTO CHIROPRACTIC WELLNESS CENTER LLC
Practice address
726 Broughton St
Orangeburg, SC 29115-6648
Phone
(803) 534-7110
Fax
(803) 534-7110
NPI assigned
Apr 15, 2008
Last updated
Sep 7, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2021

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

Authorized official

Name
Dr. Sonya Regina George, DCNPI 1780692913
Title
Chiropractor Owner
Phone
(803) 534-7110

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
Chiropractor 111N00000X 2929 SC Primary

Addresses

Primary practice location

726 Broughton St
Orangeburg, SC 29115-6648

Mailing address

726 Broughton St
Orangeburg, SC 29115-6648
Phone (803) 534-7110

Other identifiers 1

IdentifierTypeStateIssuer
GCH465MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130611000657 SC Part B Supplier - Clinic/Group Practice 2466691076 Receives reassigned benefits from 1 practitioner
Practice locations: Orangeburg, SC

National Provider Directory

National Provider Directory

Locations

1107 Cook Rd
Orangeburg, SC 29118
Phone (803) 534-7110

726 Broughton St
Orangeburg, SC 29115
Phone (803) 534-7110

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630972800000",
    "number": "1467626002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "726 BROUGHTON ST",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291156648",
            "telephone_number": "803-534-7110",
            "fax_number": "803-534-7110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "726 BROUGHTON ST",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291156648",
            "telephone_number": "803-534-7110",
            "fax_number": "803-534-7110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO CHIROPRACTIC WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-15",
        "last_updated": "2021-09-07",
        "certification_date": "2021-09-07",
        "status": "A",
        "authorized_official_last_name": "GEORGE",
        "authorized_official_first_name": "SONYA",
        "authorized_official_middle_name": "REGINA",
        "authorized_official_title_or_position": "CHIROPRACTOR OWNER",
        "authorized_official_telephone_number": "803-534-7110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "2929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GCH465",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orangeburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2021; 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.