Organization Active NPI

Rak Specific Chiropractic Clinic

  • Chiropractor
  • Mount Pleasant, SC
National Provider Identifier
1861896847
Registry record updated Oct 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2270 Issued in SC
Legal business name
RAK SPECIFIC CHIROPRACTIC CLINIC
Practice address
1303 Ben Sawyer Blvd Ste 7
Mount Pleasant, SC 29464-4589
Phone
(843) 971-8020
Fax
(843) 971-8285
NPI assigned
Oct 20, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2014

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

Authorized official

Name
Dr. Edward Rak, D.C.NPI 1447330303
Title
Owner
Phone
(843) 971-8020

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 2270 SC Primary

Addresses

Primary practice location

1303 Ben Sawyer Blvd Ste 7
Mount Pleasant, SC 29464-4589

Mailing address

1303 Ben Sawyer Blvd Ste 7
Mount Pleasant, SC 29464-4589
Phone (843) 971-8020

Other names 1

  • Rak Specific Chiropractic Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141021002047 SC Part B Supplier - Clinic/Group Practice 7214158963 Receives reassigned benefits from 1 practitioner
Practice locations: Mount Pleasant, SC

National Provider Directory

National Provider Directory
Tax ID family
Rak Specific Chiropractic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

765 Long Point Rd
Ste 102
Mount Pleasant, SC 29464
Phone (843) 971-8020

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": "1413763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413763200000",
    "number": "1861896847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 BEN SAWYER BLVD STE 7",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294644589",
            "telephone_number": "843-971-8020",
            "fax_number": "843-971-8285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 BEN SAWYER BLVD STE 7",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294644589",
            "telephone_number": "843-971-8020",
            "fax_number": "843-971-8285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAK SPECIFIC CHIROPRACTIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-20",
        "last_updated": "2014-10-20",
        "status": "A",
        "authorized_official_last_name": "RAK",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-971-8020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "2270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rak Specific Chiropractic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Oct 20, 2014; 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.