Organization Active NPI

Vital Chiropractic LLC

  • Chiropractor
  • Lexington, SC
National Provider Identifier
1912367129
Registry record updated Mar 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4117 Issued in SC
Legal business name
VITAL CHIROPRACTIC LLC
Practice address
5140 Sunset Blvd
Suite a
Lexington, SC 29072-7332
Phone
(803) 609-8503
Fax
(803) 832-1793
NPI assigned
Mar 1, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2016

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

Authorized official

Name
Dr. Samantha Messina, DCNPI 1669832879
Title
Owner
Phone
(803) 609-8503

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 4117 SC Primary

Addresses

Primary practice location

5140 Sunset Blvd
Suite a
Lexington, SC 29072-7332

Mailing address

5140 Sunset Blvd
Suite a
Lexington, SC 29072-7332
Phone (803) 609-8503

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160401000259 SC Part B Supplier - Clinic/Group Practice 2264739473 Receives reassigned benefits from 2 practitioners
Practice locations: Lexington, SC

National Provider Directory

National Provider Directory

Locations

5140 Sunset Blvd
Ste A
Lexington, SC 29072
Phone (803) 609-8503

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1456790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456790400000",
    "number": "1912367129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5140 SUNSET BLVD",
            "address_2": "SUITE A",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290727332",
            "telephone_number": "803-609-8503",
            "fax_number": "803-832-1793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5140 SUNSET BLVD",
            "address_2": "SUITE A",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290727332",
            "telephone_number": "803-609-8503",
            "fax_number": "803-832-1793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-01",
        "last_updated": "2016-03-01",
        "status": "A",
        "authorized_official_last_name": "MESSINA",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-609-8503",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "4117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2016; 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.