Individual provider Active NPI

Michael Scott McKelvey, D.C.

  • Sports Physician Chiropractor
  • Beaufort, SC
National Provider Identifier
1689676355
Registry record updated Dec 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
1890 Issued in SC
Practice address
1264 Ribaut Rd
Ste. 102
Beaufort, SC 29902-6123
Phone
(843) 524-4325
Fax
(843) 524-2885
NPI assigned
Aug 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 1890 SC Primary

Addresses

Primary practice location

1264 Ribaut Rd
Ste. 102
Beaufort, SC 29902-6123

Mailing address

1264 Ribaut Rd
Ste. 102
Beaufort, SC 29902-6123
Phone (843) 524-4325

Other identifiers 1

IdentifierTypeStateIssuer
350056792OtherSCMEDICARE RAILROAD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110104000071 SC Practitioner - Chiropractic 1355539511 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 1988
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1264 Ribaut Rd
Suite 102
Beaufort, SC 29902-6168
Phone (843) 524-4325

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1890SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Optimal Health Chiropractic Inc. Sports Physician CurrentSince Jan 1, 2003 Accepting new patients

Locations

1264 Ribaut Rd
Ste 102
Beaufort, SC 29902
Phone (843) 524-4325

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228262400000",
    "number": "1689676355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1264 RIBAUT RD",
            "address_2": "STE. 102",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299026123",
            "telephone_number": "843-524-4325",
            "fax_number": "843-524-2885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1264 RIBAUT RD",
            "address_2": "STE. 102",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299026123",
            "telephone_number": "843-524-4325",
            "fax_number": "843-524-2885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKELVEY",
        "first_name": "MICHAEL",
        "middle_name": "SCOTT",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2008-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "SC",
            "license": "1890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "350056792",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaufort, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2008; 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.