Individual provider Active NPI

Lucas Rayburn, DC

  • Chiropractor
  • Rock Hill, SC
National Provider Identifier
1477388775
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5047 Issued in SC
Practice address
1924 Mt Gallant Rd
Rock Hill, SC 29732-9434
Phone
(803) 323-5500
NPI assigned
Sep 5, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5047 SC Primary

Addresses

Primary practice location

1924 Mt Gallant Rd
Rock Hill, SC 29732-9434

Mailing address

1924 Mt Gallant Rd
Rock Hill, SC 29732-9434

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5047SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Celanese Chiropractic Health & Performance LLC Chiropractor CurrentSince Sep 8, 2024 Accepting new patients

Locations

1924 Mt Gallant Rd
Rock Hill, SC 29732
Phone (803) 323-5500

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": "1725494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1477388775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1924 MT GALLANT RD",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297329434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1924 MT GALLANT RD",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297329434",
            "telephone_number": "803-323-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYBURN",
        "first_name": "LUCAS",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-05",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "5047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; 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.