Organization Active NPI

Woodruff Chiropractic Clinic

  • Physical Medicine & Rehabilitation Physician
  • Charleston, SC
National Provider Identifier
1528136108
Registry record updated Mar 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
17193 Issued in SC
Legal business name
WOODRUFF CHIROPRACTIC CLINIC
Doing business as
Woodruff Wellness Clinic
Practice address
1019 Physician Drive
Charleston, SC 29414
Phone
(843) 571-5366
Fax
(843) 571-5659
NPI assigned
Dec 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2010

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

Authorized official

Name
Stephanie B Woodruff, D.C.
Title
Ceo
Phone
(843) 571-5366

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 2996 SC
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 2005 SC
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X 17193 SC Primary

Addresses

Primary practice location

1019 Physician Drive
Charleston, SC 29414

Mailing address

1019 Physician Drive
Charleston, SC 29414
Phone (843) 571-5366

Other names 1

  • Woodruff Wellness Clinic Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268006400000",
    "number": "1528136108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 PHYSICIAN DRIVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29414",
            "telephone_number": "843-571-5366",
            "fax_number": "843-571-5659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 PHYSICIAN DRIVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29414",
            "telephone_number": "843-571-5366",
            "fax_number": "843-571-5659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODRUFF CHIROPRACTIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2010-03-08",
        "status": "A",
        "authorized_official_last_name": "WOODRUFF",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "843-571-5366",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "2996",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "2005",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "SC",
            "license": "17193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woodruff Wellness Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2010; 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.