Individual provider Active NPI

Dominic Geno Lupori, DC

  • Chiropractor
  • Greenville, SC
National Provider Identifier
1548739949
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4375 Issued in SC
Practice address
20 Creekview CT Ste B
Greenville, SC 29615-4800
Phone
(864) 203-5388
Fax
(864) 606-6237
NPI assigned
Nov 15, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4375 SC Primary

Addresses

Primary practice location

20 Creekview CT Ste B
Greenville, SC 29615-4800

Mailing address

20 Creekview CT Ste B
Greenville, SC 29615-4800
Phone (864) 203-5388

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181227000578 SC Practitioner - Chiropractic 7315282043 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

20 Creekside CT
Suite B
Greenville, SC 29615-4800
Phone (864) 203-5388

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Spine Chiropractic LLC Chiropractor CurrentSince Nov 15, 2018 Accepting new patients

Locations

20 Creekview Ct
#B
Greenville, SC 29615
Phone (864) 203-5388

2702 E North St
Greenville, SC 29615
Phone (864) 203-5388

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": "1542240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1548739949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 CREEKVIEW CT STE B",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154800",
            "telephone_number": "864-203-5388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 CREEKVIEW CT STE B",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154800",
            "telephone_number": "864-203-5388",
            "fax_number": "864-606-6237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUPORI",
        "first_name": "DOMINIC",
        "middle_name": "GENO",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-15",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "4375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.