Active NPI
Matthew Michaud, D.C.
- Chiropractor
- Charleston, SC
National Provider Identifier
1609932953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3676
- Practice address
- 1939 Maybank Highway
Charleston, SC 29412-2170 - Phone
- (843) 795-1999
- Fax
- (843) 795-1981
- NPI assigned
- Dec 29, 2006
- Last updated
- Jan 11, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 04-2774205 | MA | |
| Chiropractor | 111N00000X | 3676 | SC | Primary |
Addresses
Primary practice location
1939 Maybank Highway
Charleston, SC 29412-2170
Mailing address
1939 Maybank Highway
Charleston, SC 29412-2170
Phone (843) 795-1999
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Y39905 | Other | MA | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3676 | SC | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pallis Chiropractic Center PC | Chiropractor | Past | Accepting new patients |
| Jpete LLC | Chiropractor | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Chiropractor
- Norwood, MA
- NPI 1902011646
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326240000000",
"number": "1609932953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1939 MAYBANK HIGHWAY",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294122170",
"telephone_number": "843-795-1999",
"fax_number": "843-795-1981"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1939 MAYBANK HIGHWAY",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294122170",
"telephone_number": "843-795-1999",
"fax_number": "843-795-1981"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICHAUD",
"first_name": "MATTHEW",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-29",
"last_updated": "2012-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MA",
"license": "04-2774205",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "SC",
"license": "3676",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "Y39905",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}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 Jan 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.