Organization Active NPI

Anderson Wellness Center

  • Chiropractor
  • Anderson, SC
National Provider Identifier
1528113362
Registry record updated May 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2663 Issued in SC
Legal business name
ANDERSON WELLNESS CENTER
Practice address
1704 E Greenville St
Anderson, SC 29621-7914
Phone
(864) 617-9300
NPI assigned
Jan 24, 2007
Last updated
May 2, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2008

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

Authorized official

Name
Kristen M Geles, DC
Title
Chiropractor
Phone
(864) 617-9300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2663 SC Primary

Addresses

Primary practice location

1704 E Greenville St
Anderson, SC 29621-7914

Mailing address

1704 E Greenville St
Anderson, SC 29621-7914
Phone (864) 617-9300

Other identifiers 1

IdentifierTypeStateIssuer
CH2663MedicaidSD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080421000114 SC Part B Supplier - Clinic/Group Practice 8820176654 Receives reassigned benefits from 1 practitioner
Practice locations: Anderson, SC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209686400000",
    "number": "1528113362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1704 E GREENVILLE ST",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296217914",
            "telephone_number": "864-617-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1704 E GREENVILLE ST",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296217914",
            "telephone_number": "864-617-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDERSON WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2008-05-02",
        "status": "A",
        "authorized_official_last_name": "GELES",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "864-617-9300",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "2663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CH2663",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2008; 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.