Lake Wylie Family Chiropractic Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2361 Issued in SC

Legal business name

LAKE WYLIE FAMILY CHIROPRACTIC INC.

Practice address

244 Latitude LN
Suite 104
Clover, SC 29710-8124

Phone

(803) 831-6500

Fax

(803) 831-6383

NPI assigned

Sep 21, 2006

Last updated

Sep 11, 2012By 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. Alan D Hartley, PH.D., DCNPI 1275576472

Title

President

Phone

(803) 831-6500

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 3

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.

• Amber Marie Pederson, D.C.

  • Chiropractor
  • Lake Wylie, SC
  • NPI 1932599693
  Medicare reassignment NPD
• Jeffery Edward Awender, D.C.

  • Chiropractor
  • Morgan Hill, CA
  • NPI 1184600306

  SC

  Medicare reassignment NPD
• Alan David Hartley, PH.D., DC

  • Chiropractor
  • Lake Wylie, SC
  • NPI 1275576472
  Authorized official Same address or phone

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347321600000",
    "number": "1891893798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 LATITUDE LN",
            "address_2": "SUITE 104",
            "city": "CLOVER",
            "state": "SC",
            "postal_code": "297108124",
            "telephone_number": "803-831-6500",
            "fax_number": "803-831-6383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 LATITUDE LN",
            "address_2": "SUITE 104",
            "city": "CLOVER",
            "state": "SC",
            "postal_code": "297108124",
            "telephone_number": "803-831-6500",
            "fax_number": "803-831-6383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE WYLIE FAMILY CHIROPRACTIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2012-09-11",
        "status": "A",
        "authorized_official_last_name": "HARTLEY",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "803-831-6500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D., DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "2361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CH2361",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GCH347",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph H Hourihan
• Mitchell Terry Keene
• Diana Kickery, LISW-CP
• Paige Killian
• Danielle Klett, LCSW
• Lake Wylie Pediatric Dentistry, LLC
• Larrea Royalty Group LLC
• Boyd Laughner, DPT
• Julie Lawrence, RN
• Leslee Falls Lengyel, LPC

• Chiropractor in Clover, SC
• Providers in Clover, SC by specialty
• Chiropractor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.