Active NPI
Charles Ray Renick, DC MST
- Chiropractor
- Columbia, SC
National Provider Identifier
1760592471
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- SC1686
- Practice address
- 4514 St Andrews Road
Columbia, SC 29210 - Phone
- (803) 731-8121
- Fax
- (803) 731-8121
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | SC1686 | SC | Primary |
Addresses
Primary practice location
4514 St Andrews Road
Columbia, SC 29210
Mailing address
4514 St Andrews Road
Columbia, SC 29210
Phone (803) 731-8121
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CH1686 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080110000246 | SC | Practitioner - Chiropractic | 6709966138 | Practice locations: Columbia, SC |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - West Sunnyvale, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
4514 Saint Andrews Rd
Columbia, SC 29210-4100
Phone (803) 731-8121
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SC1686 | SC | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1760592471",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4514 ST ANDREWS ROAD",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "29210",
"telephone_number": "803-731-8121",
"fax_number": "803-731-8121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4514 ST ANDREWS ROAD",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "29210",
"telephone_number": "803-731-8121",
"fax_number": "803-731-8121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENICK",
"first_name": "CHARLES",
"middle_name": "RAY",
"name_prefix": "Dr.",
"credential": "DC MST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "SC",
"license": "SC1686",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "CH1686",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.