Individual provider Active NPI

Paul Waller Friedman, D.C.

  • Chiropractor
  • Charleston, SC
National Provider Identifier
1730138165
Registry record updated Jul 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2136 Issued in SC
Practice address
1124 Sam Rittenberg Blvd
Suite #4
Charleston, SC 29407-3362
Phone
(843) 225-2588
Fax
(843) 225-2599
NPI assigned
May 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2136 SC Primary

Addresses

Primary practice location

1124 Sam Rittenberg Blvd
Suite #4
Charleston, SC 29407-3362

Mailing address

1505 Frogleg CT
Mt Pleasant, SC 29466-9160
Phone (843) 270-2286

Other identifiers 1

IdentifierTypeStateIssuer
CH2136MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Paul W Friedman DC LLC Chiropractor PastSince Jan 1, 1990 Accepting new patients
Cromer Chiropractic Chiropractor Past Accepting new patients
Abundant Life Chiropractic Center Chiropractor Past Accepting new patients
Central Avenue Healthworks, P.a. Chiropractor Past Accepting new patients

Organizations & group practices 4

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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184544000000",
    "number": "1730138165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 FROGLEG CT",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294669160",
            "telephone_number": "843-270-2286",
            "fax_number": "843-225-2599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 SAM RITTENBERG BLVD",
            "address_2": "SUITE #4",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294073362",
            "telephone_number": "843-225-2588",
            "fax_number": "843-225-2599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDMAN",
        "first_name": "PAUL",
        "middle_name": "WALLER",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2007-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "2136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CH2136",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; 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.