Organization Active NPI

Healthy4Life Integrated Medicine, Inc

  • Specialist
  • Goose Creek, SC
National Provider Identifier
1811148877
Registry record updated Jun 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
HEALTHY4LIFE INTEGRATED MEDICINE, INC
Practice address
118 Springhall Dr Ste B
Goose Creek, SC 29445-5360
Phone
(843) 735-7115
Fax
(843) 735-7114
NPI assigned
Oct 8, 2008
Last updated
Jun 23, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2020

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

Authorized official

Name
Dr. Bryan S Aldrich, DCNPI 1053353979
Title
Owner/President
Phone
(843) 735-7115

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
Specialist 174400000X Primary

Addresses

Primary practice location

118 Springhall Dr Ste B
Goose Creek, SC 29445-5360

Mailing address

118 Springhall Dr Ste B
Goose Creek, SC 29445-5360
Phone (843) 735-7115

Other names 1

  • Low Country Clinic, INC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090728000279 SC Part B Supplier - Clinic/Group Practice 7719030584 Receives reassigned benefits from 5 practitioners
Practice locations: Goose Creek, SC

National Provider Directory

National Provider Directory

Locations

118 Springhall Dr
Ste A
Goose Creek, SC 29445
Phone (843) 376-3112

118 Springhall Dr
Ste D
Goose Creek, SC 29445
Phone (843) 735-7115

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1223424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592870400000",
    "number": "1811148877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 SPRINGHALL DR STE B",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294455360",
            "telephone_number": "843-735-7115",
            "fax_number": "843-735-7114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 SPRINGHALL DR STE B",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294455360",
            "telephone_number": "843-735-7115",
            "fax_number": "843-735-7114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY4LIFE INTEGRATED MEDICINE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-08",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A",
        "authorized_official_last_name": "ALDRICH",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "843-735-7115",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Low Country Clinic, INC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Goose Creek, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; 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.