Individual provider Active NPI

Mackenzie Paige Buck, DC

  • Chiropractor
  • Summerville, SC
National Provider Identifier
1689326365
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4760 Issued in SC
Practice address
1907 Varner St Ste C2
Summerville, SC 29486-8104
Phone
(843) 419-6955
NPI assigned
Jan 24, 2022
Last updated
Aug 8, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4760 SC Primary

Addresses

Primary practice location

1907 Varner St Ste C2
Summerville, SC 29486-8104

Mailing address

820 Cartwright Dr
Charleston, SC 29414-5128
Phone (304) 216-9399

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220524000244 SC Practitioner - Chiropractic 2264819663 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arentsen Family Chiropractic LLCGroup PAC ID 5799187332, 2 clinicians

Practice addresses (Care Compare)

1907 Varner St
Suite C2
Summerville, SC 29486-8104
Phone (843) 419-6955

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4760SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arentsen Family Chiropractic LLC Chiropractor CurrentSince Sep 25, 2023 Accepting new patients
Live for Wellness Johns Island Chiropractor CurrentSince Feb 1, 2022 Accepting new patients

Locations

3417 Shelby Ray Ct
Ste C
Charleston, SC 29414
Phone (843) 556-6000

1907 Varner St
Ste C2
Summerville, SC 29486
Phone (414) 839-9220

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1642982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1689326365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 CARTWRIGHT DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145128",
            "telephone_number": "304-216-9399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 VARNER ST STE C2",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294868104",
            "telephone_number": "843-419-6955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCK",
        "first_name": "MACKENZIE",
        "middle_name": "PAIGE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-24",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "4760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; 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.