The Upstate Clinic of Specific Chir

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2941 Issued in SC

Legal business name

THE UPSTATE CLINIC OF SPECIFIC CHIR

Practice address

838 Powdersville Rd
Suite R
Easley, SC 29642-3703

Phone

(864) 855-3255

Fax

(864) 855-3254

NPI assigned

May 9, 2007

Last updated

Nov 28, 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

Stephen A Conicello, D.C.

Title

President

Phone

(864) 855-3255

Specialties & licenses 2

Addresses

Other names 1

• The Upstate Clinic of Specific Chiropractic, P.A. Other name

Locations

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196208000000",
    "number": "1679787618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "838 POWDERSVILLE RD",
            "address_2": "SUITE R",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296423703",
            "telephone_number": "864-855-3255",
            "fax_number": "864-855-3254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "838 POWDERSVILLE RD",
            "address_2": "SUITE R",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296423703",
            "telephone_number": "864-855-3255",
            "fax_number": "864-855-3254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE UPSTATE CLINIC OF SPECIFIC CHIR",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2007-11-28",
        "status": "A",
        "authorized_official_last_name": "CONICELLO",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-855-3255",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "2941",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "3243",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Upstate Clinic of Specific Chiropractic, P.A.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Anne Terry
• Nancy S Terry, M.A.
• Ellen Tessler, OTR/L
• The Medicine Mart
• The Potter's House Family Counseling
• Rachel Lindsay Thoma, L.AC
• Thomas R Prostko (Easley Gastroenterology)
• Heather Thomason, PTA
• Allan James Thompson Jr., M.D.
• Myrna Harris Thompson, CRNA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.