The Back Shak LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

THE BACK SHAK LLC

Practice address

223 Fresh Dr Unit B
Myrtle Beach, SC 29579-4462

Phone

(843) 903-5772

Fax

(843) 492-4020

NPI assigned

Jan 8, 2021

Organization subpart

No

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

Authorized official

Name

Mrs. Nicole Causey

Title

Owner

Phone

(843) 267-0560

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 1

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

• Zachary Grant Causey, DC

  • Chiropractor
  • Myrtle Beach, SC
  • NPI 1013025931
  Medicare reassignment NPD

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

{
    "created_epoch": "1610064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610064000000",
    "number": "1821686460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 DRAGONFLY DR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295795263",
            "telephone_number": "843-267-0560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 FRESH DR UNIT B",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295794462",
            "telephone_number": "843-903-5772",
            "fax_number": "843-492-4020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BACK SHAK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-08",
        "last_updated": "2021-01-08",
        "certification_date": "2021-01-08",
        "status": "A",
        "authorized_official_last_name": "CAUSEY",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-267-0560",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Chiropractor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2021; 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.