Individual provider Active NPI

Shauna M. Mazique, DC

  • Chiropractor
  • Mt Pleasant, SC
National Provider Identifier
1609845841
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3042 Issued in SC
Practice address
498 Wando Park Blvd Ste 1150
Mt Pleasant, SC 29464-7971
Phone
(843) 940-5166
NPI assigned
Mar 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3042 SC Primary

Addresses

Primary practice location

498 Wando Park Blvd Ste 1150
Mt Pleasant, SC 29464-7971

Mailing address

498 Wando Park Blvd Ste 1150
Mt Pleasant, SC 29464-7971
Phone (843) 940-5166

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060307000464 SC Practitioner - Chiropractic 7810904430 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

498 Wando Park Blvd
Suite 1150
Mt Pleasant, SC 29464-7971
Phone (843) 940-5166

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3042SCMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Milo Chiropractic LLC Chiropractor PastSince Sep 24, 2021 Accepting new patients
Island Breeze Chiropractic Inc Chiropractor Past Accepting new patients
Advanced Chiropractic Center Chiropractor Past Accepting new patients

Organizations & group practices 4

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": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1609845841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "498 WANDO PARK BLVD STE 1150",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294647971",
            "telephone_number": "843-940-5166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "498 WANDO PARK BLVD STE 1150",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294647971",
            "telephone_number": "843-940-5166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZIQUE",
        "first_name": "SHAUNA",
        "middle_name": "M.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-17",
        "last_updated": "2023-10-11",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "3042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; 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.