Individual provider Active NPI

Emily De Jesus

  • Chiropractor
  • Rock Hill, SC
National Provider Identifier
1578308383
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5094 Issued in SC
Practice address
154 Amendment Ave Ste 104
Rock Hill, SC 29732-3156
Phone
(803) 329-8108
NPI assigned
Jun 25, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 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 5094 SC Primary

Addresses

Primary practice location

154 Amendment Ave Ste 104
Rock Hill, SC 29732-3156

Mailing address

154 Amendment Ave Ste 104
Rock Hill, SC 29732-3156
Phone (732) 608-1754

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251105000027 NC Practitioner - Chiropractic 2163912551 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

624 Tyvola Rd
Suite 100
Charlotte, NC 28217-3585

9215 Martin Ter
Gainesville, GA 30506-5893

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5094SCMDProfessional Counselor
5949NCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Life Chiropractic Chiropractor CurrentSince Jul 22, 2025 Accepting new patients

Locations

624 Tyvola Rd
Ste 100
Charlotte, NC 28217
Phone (704) 770-8436

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": "1719273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1578308383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 AMENDMENT AVE STE 104",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297323156",
            "telephone_number": "732-608-1754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 AMENDMENT AVE STE 104",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297323156",
            "telephone_number": "803-329-8108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE JESUS",
        "first_name": "EMILY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-25",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "5094",
            "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 Jun 25, 2024; 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.