Individual provider Active NPI

Charles T Rogers Jr., DC

  • Chiropractor
  • Surfside Beach, SC
National Provider Identifier
1629139043
Registry record updated Aug 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2486 Issued in SC
Practice address
1665 Glenns Bay Rd
Surfside Beach, SC 29575-4836
Phone
(843) 215-2324
Fax
(843) 215-0541
NPI assigned
Dec 12, 2006
Last updated
Aug 23, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2486 SC Primary

Addresses

Primary practice location

1665 Glenns Bay Rd
Surfside Beach, SC 29575-4836

Mailing address

1665 Glenns Bay Rd
Surfside Beach, SC 29575-4836
Phone (843) 215-2324

Other identifiers 2

IdentifierTypeStateIssuer
350050597OtherSCRAILROAD MEDICARE
CH2486MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120320000085 SC Practitioner - Chiropractic 5597925123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3334 S Hwy 17
Murrells Inlet, SC 29576-7634
Phone (843) 655-5869

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2486SCMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Murrells Inlet Chiropractic Chiropractor CurrentSince Jan 30, 2018 Accepting new patients

Locations

3334 S Highway 17
Murrells Inlt, SC 29576
Phone (843) 633-1179

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345680000000",
    "number": "1629139043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1665 GLENNS BAY RD",
            "city": "SURFSIDE BEACH",
            "state": "SC",
            "postal_code": "295754836",
            "telephone_number": "843-215-2324",
            "fax_number": "843-215-0541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1665 GLENNS BAY RD",
            "city": "SURFSIDE BEACH",
            "state": "SC",
            "postal_code": "295754836",
            "telephone_number": "843-215-2324",
            "fax_number": "843-215-0541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "CHARLES",
        "middle_name": "T",
        "name_suffix": "Jr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2012-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "2486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "350050597",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CH2486",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Surfside Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2012; 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.