Organization Active NPI

Five Forks Chiropractic PA

  • Chiropractor
  • Simpsonville, SC
National Provider Identifier
1871680728
Registry record updated Mar 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2612, 2772 Issued in 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
Last updated
Mar 6, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2012

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

Authorized official

Name
Dr. Susan M. McDowell, D.C.NPI 1730278839
Title
President
Phone
(864) 458-7008

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 2612, 2772 SC Primary

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031215000258 SC Part B Supplier - Clinic/Group Practice 5698672145 Receives reassigned benefits from 2 practitioners
Practice locations: Simpsonville, SC

National Provider Directory

National Provider Directory

Locations

7 Five Fork Plaza Ct
Ste D
Simpsonville, SC 29681
Phone (864) 458-7008

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330992000000",
    "number": "1871680728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 FIVE FORK PLAZA CT STE D",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296815461",
            "telephone_number": "864-458-7008",
            "fax_number": "864-458-7002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 FIVE FORK PLAZA CT STE D",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296815461",
            "telephone_number": "864-458-7008",
            "fax_number": "864-458-7002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE FORKS CHIROPRACTIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2012-03-06",
        "status": "A",
        "authorized_official_last_name": "MCDOWELL",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-458-7008",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "2612, 2772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simpsonville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2012; 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.