Individual provider Active NPI

Luis Omar Luciano Perez, DC

  • Chiropractor
  • Spartanburg, SC
National Provider Identifier
1861182800
Registry record updated May 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4950 Issued in PR
Practice address
851 John B White Sr Blvd
Spartanburg, SC 29306-4037
Phone
(864) 707-0055
NPI assigned
May 12, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4950 PR Primary

Addresses

Primary practice location

851 John B White Sr Blvd
Spartanburg, SC 29306-4037

Mailing address

105 Sigmon Dr
Mauldin, SC 29662-1872
Phone (787) 462-9505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240503000908 SC Practitioner - Chiropractic 6608216981 Reassigns benefits to 1 organization
I20260611003770 NC Practitioner - Chiropractic 6608216981 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 2023
Medicare assignment
May accept Medicare assignment
Group practices
Active Living Chiropractic IncGroup PAC ID 5698804300, 5 clinicians

Practice addresses (Care Compare)

704 E Arlington Blvd
Greenville, NC 27858-5809
Phone (252) 756-6111

851 John B White Sr Blvd
Spartanburg, SC 29306-4037
Phone (864) 707-0055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4950PRMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Align Services Spartanburg West, LLC Chiropractor CurrentSince May 14, 2023 Accepting new patients
Align Services Spartanburg West, LLC Chiropractor CurrentSince Dec 20, 2023 Accepting new patients

Locations

851 John B White SR Blvd
Spartanburg, SC 29306
Phone (864) 591-8769

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1683849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683849600000",
    "number": "1861182800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 SIGMON DR",
            "city": "MAULDIN",
            "state": "SC",
            "postal_code": "296621872",
            "telephone_number": "787-462-9505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 JOHN B WHITE SR BLVD",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293064037",
            "telephone_number": "864-707-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCIANO PEREZ",
        "first_name": "LUIS",
        "middle_name": "OMAR",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-12",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PR",
            "license": "4950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2023; 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.

Verify at the official NPI Registry.