Costa Clinic of Chiropractic, LLC

Primary specialty

Orthopedic ChiropractorTaxonomy code 111NX0800X

License

3081 Issued in SC

Legal business name

COSTA CLINIC OF CHIROPRACTIC, LLC

Practice address

9945 Charlotte Hwy
Fort Mill, SC 29715-7134

Phone

(803) 802-8601

Fax

(803) 802-7969

NPI assigned

Jan 2, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Michael Thomas Costa, D.C.NPI 1629183108

Title

Owner

Phone

(803) 802-8601

Specialties & licenses 1

Addresses

Practitioners 2

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

• Michael Thomas Costa, D.C.

  • Chiropractor
  • Fort Mill, SC
  • NPI 1629183108
  NPD (past) Authorized official
• Jonathan Cory Broyles, D.C.

  • Chiropractor
  • Fort Mill, SC
  • NPI 1013253194
  NPD (past)

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689731531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9945 CHARLOTTE HWY",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297157134",
            "telephone_number": "803-802-8601",
            "fax_number": "803-802-7969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9945 CHARLOTTE HWY",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297157134",
            "telephone_number": "803-802-8601",
            "fax_number": "803-802-7969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSTA CLINIC OF CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COSTA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-802-8601",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Orthopedic",
            "state": "SC",
            "license": "3081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Core I Med LLC
• Core Physical Therapy LLC
• Kathryn Corn, PT, DPT
• Kimberly Correa, FNP
• Corrective Chiropractic Fort Mill
• Michael Thomas Costa, D.C.
• Julia Costello, M.S., CCC-SLP
• Garrett Costin, RBT
• Alicia Renee Costner, BCABA
• Coxon Lifestyle Management Clinic, LLC

• Orthopedic Chiropractor in Fort Mill, SC
• Providers in Fort Mill, SC by specialty
• Orthopedic Chiropractor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.