Organization Active NPI

Williamsburg Chiropractic and Wellness Center LLC

  • Chiropractor
  • Kingstree, SC
National Provider Identifier
1801288949
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
WILLIAMSBURG CHIROPRACTIC AND WELLNESS CENTER LLC
Practice address
303 E Main St
Kingstree, SC 29556-3512
Phone
(843) 325-5302
NPI assigned
Feb 26, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Authorized official

Name
Mr. Kevin Ashley Morris, DCNPI 1619910262
Title
Owner
Phone
(843) 355-5131

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

303 E Main St
Kingstree, SC 29556-3512

Mailing address

303 E Main St
Kingstree, SC 29556

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150428000731 SC Part B Supplier - Clinic/Group Practice 6103145057 Receives reassigned benefits from 1 practitioner
Practice locations: Kingstree, SC

National Provider Directory

National Provider Directory

Locations

303 E Main St
Kingstree, SC 29556
Phone (843) 325-5302

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1424908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706572800000",
    "number": "1801288949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 E MAIN ST",
            "city": "KINGSTREE",
            "state": "SC",
            "postal_code": "29556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 E MAIN ST",
            "city": "KINGSTREE",
            "state": "SC",
            "postal_code": "295563512",
            "telephone_number": "843-325-5302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAMSBURG CHIROPRACTIC AND WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-26",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "ASHLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-355-5131",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingstree, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; 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.