Active NPI
Ty Wesley Maxie, DC
- Chiropractor
- North Charleston, SC
National Provider Identifier
1679344329
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 5037
- Practice address
- 5750 Rivers Ave Ste a
North Charleston, SC 29406-6029 - Phone
- (843) 723-6475
- NPI assigned
- Jan 11, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 5037 | SC | Primary |
Addresses
Primary practice location
5750 Rivers Ave Ste a
North Charleston, SC 29406-6029
Mailing address
1235 Ashley Garden Blvd Unit 1022
Charleston, SC 29414-9212
Phone (812) 216-8964
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5037 | SC | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1704931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704931200000",
"number": "1679344329",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1235 ASHLEY GARDEN BLVD UNIT 1022",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294149212",
"telephone_number": "812-216-8964"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5750 RIVERS AVE STE A",
"city": "NORTH CHARLESTON",
"state": "SC",
"postal_code": "294066029",
"telephone_number": "843-723-6475"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAXIE",
"first_name": "TY",
"middle_name": "WESLEY",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-01-11",
"last_updated": "2024-01-11",
"certification_date": "2024-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "SC",
"license": "5037",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North 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, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.