Active NPI
Matthew Michael Antonucci, D.C., D.A.C.N.B
- Neurology Chiropractor
- Mount Pleasant, SC
National Provider Identifier
1851696165
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Chiropractor
- License
- 3613
- Practice address
- 874 Whipple Rd
Suite 200
Mount Pleasant, SC 29464-8900 - Phone
- (843) 882-5433
- NPI assigned
- Jan 18, 2011
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Chiropractor | 111NN0400X | 3613 | SC | Primary |
| Nutrition Chiropractor | 111NN1001X | 3613 | SC | |
| Pediatric Chiropractor | 111NP0017X | 3613 | SC |
Addresses
Primary practice location
874 Whipple Rd
Suite 200
Mount Pleasant, SC 29464-8900
Mailing address
874 Whipple Rd
Suite 200
Mount Pleasant, SC 29464-8900
Phone (843) 882-5433
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3613 | SC | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1295308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295308800000",
"number": "1851696165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "874 WHIPPLE RD",
"address_2": "SUITE 200",
"city": "MOUNT PLEASANT",
"state": "SC",
"postal_code": "294648900",
"telephone_number": "843-882-5433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "874 WHIPPLE RD",
"address_2": "SUITE 200",
"city": "MOUNT PLEASANT",
"state": "SC",
"postal_code": "294648900",
"telephone_number": "843-882-5433"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANTONUCCI",
"first_name": "MATTHEW",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "D.C., D.A.C.N.B",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-01-18",
"last_updated": "2011-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "111NN0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Neurology",
"state": "SC",
"license": "3613",
"primary": true
},
{
"code": "111NN1001X",
"taxonomy_group": "",
"desc": "Chiropractor, Nutrition",
"state": "SC",
"license": "3613",
"primary": false
},
{
"code": "111NP0017X",
"taxonomy_group": "",
"desc": "Chiropractor, Pediatric Chiropractor",
"state": "SC",
"license": "3613",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Pleasant, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.