NPIMap

Organization Active NPI

Enhanced Living Chiropractic

  • Chiropractor
  • Greer, SC
National Provider Identifier
1700032174
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3385 Issued in SC
Legal business name
ENHANCED LIVING CHIROPRACTIC
Practice address
140 Sage Creek Way
Greer, SC 29650
Phone
(864) 848-0640
Fax
(864) 848-0646
NPI assigned
Aug 17, 2008
Last updated
Dec 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Authorized official

Name
Tracy Allen
Title
Manager
Phone
(864) 848-0640

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3385 SC Primary

Addresses

Primary practice location

140 Sage Creek Way
Greer, SC 29650

Mailing address

140 Sage Creek Way
Greer, SC 29650
Phone (864) 848-0640

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091022000272 SC Part B Supplier - Clinic/Group Practice 8022155142 Receives reassigned benefits from 5 practitioners
Practice locations: Greer, SC

National Provider Directory

National Provider Directory
Tax ID family
Enhanced Living Chiropractic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

1250 Merry St
Augusta, GA 30904
Phone (706) 586-1077

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1218931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670198400000",
    "number": "1700032174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 SAGE CREEK WAY",
            "city": "GREER",
            "state": "SC",
            "postal_code": "29650",
            "telephone_number": "864-848-0640",
            "fax_number": "864-848-0646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 SAGE CREEK WAY",
            "city": "GREER",
            "state": "SC",
            "postal_code": "29650",
            "telephone_number": "864-848-0640",
            "fax_number": "864-848-0646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENHANCED LIVING CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-17",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "864-848-0640"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "3385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greer, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; 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.