Active NPI
Marc David Wilson, DC
- Chiropractor
- Greenville, SC
National Provider Identifier
1902498397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 4640
- Practice address
- 3302 New Easley Hwy
Greenville, SC 29611-7137 - Phone
- (864) 243-8158
- NPI assigned
- Feb 7, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 4640 | SC | Primary |
Addresses
Primary practice location
3302 New Easley Hwy
Greenville, SC 29611-7137
Mailing address
105 Ladybank CT
Easley, SC 29640-7187
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Balanced Health LLC | Chiropractor | Current | Accepting new patients |
Locations
3302 New Easley Hwy
Greenville, SC 29611
Phone (864) 243-8158
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Chiropractor
- Greenville, SC
- NPI 1619543014
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612656000000",
"number": "1902498397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 LADYBANK CT",
"city": "EASLEY",
"state": "SC",
"postal_code": "296407187"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3302 NEW EASLEY HWY",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296117137",
"telephone_number": "864-243-8158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "MARC",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-02-07",
"last_updated": "2021-02-07",
"certification_date": "2021-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "SC",
"license": "4640",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.