Three Fountains Chiropractic, Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2108 Issued in SC

Legal business name

THREE FOUNTAINS CHIROPRACTIC, INC.

Practice address

1926 S Lake Dr
Lexington, SC 29073-8282

Phone

(803) 808-1897

NPI assigned

Oct 4, 2005

Last updated

Aug 24, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. David R Gooldy, DCNPI 1972590040

Title

President

Phone

(803) 808-1897

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David R Gooldy, DC

  • Chiropractor
  • Lexington, SC
  • NPI 1972590040
  Authorized official Same address or phone

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187913600000",
    "number": "1679560742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 84428",
            "address_2": "1926 SOUTH LAKE DRIVE",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290730008",
            "telephone_number": "803-808-1897",
            "fax_number": "803-808-1297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1926 S LAKE DR",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290738282",
            "telephone_number": "803-808-1897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE FOUNTAINS CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-04",
        "last_updated": "2007-08-24",
        "status": "A",
        "authorized_official_last_name": "GOOLDY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "803-808-1897",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "2108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dorissa Thompson
• Genelle Thompson
• Tommy Denton Thompson, DMD
• William Robert Thorner, DMD
• George R. Thrana, MSW, LMSW
• Thrive Wellness and Rehab, LLC
• Lindsey Autumn Thurmon, NP
• Tides of Life Home Care, LLC (Senior Helpers of Lexington SC)
• Mark E Tidsworth, M.ED.
• Claire Stevens Tidwell, MS, RDN, LD, CNSC

• Chiropractor in Lexington, SC
• Providers in Lexington, SC by specialty
• Chiropractor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.