Individual provider Active NPI

Zachary Alan Woodrum, DC

  • Chiropractor
  • Walterboro, SC
National Provider Identifier
1588066385
Registry record updated Sep 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3979 Issued in SC
Practice address
4510 Jefferies Hwy
Walterboro, SC 29488-6489
Phone
(843) 539-1111
NPI assigned
Sep 23, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3979 SC Primary

Addresses

Primary practice location

4510 Jefferies Hwy
Walterboro, SC 29488-6489

Mailing address

103 Fairview Ave
Walterboro, SC 29488-3576
Phone (304) 389-1924

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20141203000011 SC Practitioner - Chiropractic 5991027922
I20160419000134 OH Practitioner - Chiropractic 5991027922 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1716 11TH St
Portsmouth, OH 45662-4528
Phone (740) 353-4248

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph E Valli, D.C., Inc Chiropractor CurrentSince Apr 1, 2016 Accepting new patients
Scioto Valley Chiropractic and Rehab Center LLC Chiropractor CurrentSince Oct 5, 2020 Accepting new patients

Locations

1716 11th St
Portsmouth, OH 45662
Phone (740) 353-4248

1420 Chillicothe St
Portsmouth, OH 45662
Phone (740) 354-8824

Organizations & group practices 2

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": "1411430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411430400000",
    "number": "1588066385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 FAIRVIEW AVE",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294883576",
            "telephone_number": "304-389-1924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 JEFFERIES HWY",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294886489",
            "telephone_number": "843-539-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODRUM",
        "first_name": "ZACHARY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-23",
        "last_updated": "2014-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "3979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walterboro, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2014; 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.