Five Forks Chiropractic PA
Organization Active NPI Chiropractor · Simpsonville, SC
NPI 1871680728 · NPPES record last updated Mar 6, 2012
Key facts
- NPI
- 1871680728
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 2612, 2772 (SC)
- Legal business name
- FIVE FORKS CHIROPRACTIC PA
- Practice address
- 7 Five Fork Plaza CT Ste D
Simpsonville, SC 29681-5461 - Phone
- (864) 458-7008
- Fax
- (864) 458-7002
- NPI assigned
- Oct 10, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Susan M. McDowell, D.C.
- Title
- President
- Phone
- (864) 458-7008
Practitioners 2
-
Edwin Heathman Bost IV, D.C.
-
Susan Marie McDowell, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031215000258 | SC | Part B Supplier - Clinic/Group Practice | 5698672145 |
Receives reassigned benefits from 2 practitioners Practice locations: Simpsonville, SC |
National Provider Directory
Locations
7 Five Fork Plaza Ct
Ste D
Simpsonville, SC 29681
Phone (864) 458-7008
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 2612, 2772 | SC | Yes |
Addresses
Primary practice location
7 Five Fork Plaza CT Ste D
Simpsonville, SC 29681-5461
Mailing address
7 Five Fork Plaza CT Ste D
Simpsonville, SC 29681-5461
Phone (864) 458-7008
Other providers in Simpsonville, SC
- Kathleen Lee Fiddie
- Ashton Stevens Finley
- First Physical Therapy, LLC
- Christine Rister Fisher
- Fit for a King
- Five Forks Dental Care, Inc
- Five Forks Pharmacy LLC
- Five Forks Vision, LLC
- Lindsey Flavell
- Avery Lamar Fleming
All providers in Simpsonville, SC · Chiropractor in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.