Organization Active NPI

Living Well Family Chiropractic, LLC

  • Chiropractor
  • Aiken, SC
National Provider Identifier
1487886198
Registry record updated Aug 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
LIVING WELL FAMILY CHIROPRACTIC, LLC
Practice address
104 Florence St SW
Suite B
Aiken, SC 29801-3890
Phone
(803) 226-0051
Fax
(803) 226-0052
NPI assigned
Aug 13, 2009
Last updated
Aug 13, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2009

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

Authorized official

Name
Dr. Christopher Michael Ethridge, DCNPI 1093941346
Title
Manager
Phone
(803) 226-0051

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 Primary

Addresses

Primary practice location

104 Florence St SW
Suite B
Aiken, SC 29801-3890

Mailing address

104 Florence St SW
Suite B
Aiken, SC 29801-3890
Phone (803) 226-0051

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091015000235 SC Part B Supplier - Clinic/Group Practice 1850437203 Receives reassigned benefits from 1 practitioner
Practice locations: Aiken, SC

National Provider Directory

National Provider Directory

Locations

104 Florence St SW
#B
Aiken, SC 29801
Phone (803) 226-0051

104B Florence St SW
Aiken, SC 29801
Phone (803) 226-0051

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": "1250121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250121600000",
    "number": "1487886198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 FLORENCE ST SW",
            "address_2": "SUITE B",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298013890",
            "telephone_number": "803-226-0051",
            "fax_number": "803-226-0052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 FLORENCE ST SW",
            "address_2": "SUITE B",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298013890",
            "telephone_number": "803-226-0051",
            "fax_number": "803-226-0052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WELL FAMILY CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-13",
        "last_updated": "2009-08-13",
        "status": "A",
        "authorized_official_last_name": "ETHRIDGE",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "803-226-0051",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiken, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2009; 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.