Tega Cay Chiropractic - Sports Injury Clinic Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2295 Issued in SC

Legal business name

TEGA CAY CHIROPRACTIC - SPORTS INJURY CLINIC INC

Practice address

101 Stone Village Drive
Fort Mill, SC 29708

Phone

(803) 802-5322

Fax

(803) 802-5665

NPI assigned

Jul 18, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Randall J Conger, DC CCSPNPI 1649471046

Title

President

Phone

(803) 802-5322

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Randall J Conger DC Other name

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, and the practitioner matching its NPPES authorized official.

• Randall James Conger, DC

  • Chiropractor
  • Fort Mill, SC
  • NPI 1649471046
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871511766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 STONE VILLAGE DRIVE",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "29708",
            "telephone_number": "803-802-5322",
            "fax_number": "803-802-5665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 STONE VILLAGE DRIVE",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "29708",
            "telephone_number": "803-802-5322",
            "fax_number": "803-802-5665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEGA CAY CHIROPRACTIC - SPORTS INJURY CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CONGER",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "803-802-5322",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC CCSP"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "2295",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "1915",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CH1916",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Randall J Conger DC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Tara the Rd LLC
• Taylor Medical Care LLC
• Kathryn Grace Taylor, OTD, OTR/L
• Staranna Taylor, RBT
• TD Premier Enterprises LLC
• Tega Cay Psychiatric Associates, PA
• Melissa Leigh Terpstra, D.P.T.
• Brenda Terry, LAC
• Holly Tesimale
• The Chewfasa Group, Inc. (Home Care of Rock Hill, SC)

• Chiropractor in Fort Mill, SC
• Providers in Fort Mill, SC by specialty
• Chiropractor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.