Individual provider Active NPI

Robert Richard Maurer Jr.

  • Chiropractor
  • Greenville, SC
National Provider Identifier
1669974739
Registry record updated Mar 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4305 Issued in SC
Practice address
19 Mohawk Dr
Greenville, SC 29609-5726
Phone
(386) 846-8362
NPI assigned
Mar 6, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4305 SC Primary

Addresses

Primary practice location

19 Mohawk Dr
Greenville, SC 29609-5726

Mailing address

230 Roper Mountain Road Ext Apt 618F
Greenville, SC 29615-4868
Phone (386) 846-8362

Other identifiers 1

IdentifierTypeStateIssuer
823105898MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181227000794 SC Practitioner - Chiropractic 7113262346 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

19 Mohawk Dr
Greenville, SC 29609-5726
Phone (864) 568-5293

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4305SCMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Health LLC Chiropractor CurrentSince Apr 18, 2018 Accepting new patients

Locations

19 Mohawk Dr
Greenville, SC 29609
Phone (386) 846-8362

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": "1520294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520294400000",
    "number": "1669974739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 ROPER MOUNTAIN ROAD EXT APT 618F",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154868",
            "telephone_number": "386-846-8362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 MOHAWK DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296095726",
            "telephone_number": "386-846-8362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAURER",
        "first_name": "ROBERT",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-06",
        "last_updated": "2018-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "4305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "823105898",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2018; 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.