Live for Wellness Johns Island

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

LIVE FOR WELLNESS JOHNS ISLAND

Practice address

1803 Crowne Commons Way
Suite 1-a
Johns Island, SC 29455

Phone

(843) 737-6960

Fax

(843) 737-6960

NPI assigned

Oct 9, 2019

Organization subpart

Yes

Parent organization

LIVE FOR WELLNESS CHIROPRACTIC CENTERAs reported in NPPES

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

Authorized official

Name

Dr. Jennifer Lynn Perdue, DCNPI 1790031961

Title

Owner

Phone

(843) 737-6960

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Part of

Live for Wellness Chiropractic Center

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Live for Wellness Chiropractic Center

  • Chiropractor
  • Charleston, SC
  • NPI 1275882995
  NPPES parent name

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Lynn Perdue, D.C., B.S.

  • Chiropractor
  • Charleston, SC
  • NPI 1790031961
  Medicare reassignment Care Compare group NPD Authorized official
• Monyka Josephine Lee, DC

  • Chiropractor
  • Johns Island, SC
  • NPI 1760146138
  Medicare reassignment Care Compare group
• Mackenzie Paige Buck, DC

  • Chiropractor
  • Summerville, SC
  • NPI 1689326365
  NPD
• Tara Lashay Johnson, DC

  • Chiropractor
  • Charleston, SC
  • NPI 1447899638
  NPD

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

{
    "created_epoch": "1570579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576540800000",
    "number": "1689216863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3417 SHELBY RAY CT STE C",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145895",
            "telephone_number": "843-737-6960",
            "fax_number": "843-737-6960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1803 CROWNE COMMONS WAY",
            "address_2": "SUITE 1-A",
            "city": "JOHNS ISLAND",
            "state": "SC",
            "postal_code": "29455",
            "telephone_number": "843-737-6960",
            "fax_number": "843-737-6960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE FOR WELLNESS JOHNS ISLAND",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIVE FOR WELLNESS CHIROPRACTIC CENTER",
        "enumeration_date": "2019-10-09",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A",
        "authorized_official_last_name": "PERDUE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-737-6960",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CH3757",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1124551064",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Johns Island, SC
• Providers in Johns Island, SC by specialty
• Chiropractor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.