One Source Integrative Medicine

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

ONE SOURCE INTEGRATIVE MEDICINE

Practice address

1601A W Lucas St
Florence, SC 29501-1225

Phone

(843) 992-7604

NPI assigned

Feb 10, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer M Evans, DCNPI 1578993820

Title

Owner

Phone

(843) 992-7604

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 4

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

• Jennifer Marlena Evans, D.C

  • Chiropractor
  • Florence, SC
  • NPI 1578993820
  Medicare reassignment Care Compare group NPD Authorized official
• Jessica Sanders

  • Family Nurse Practitioner
  • Florence, SC
  • NPI 1134841372
  Medicare reassignment Care Compare group NPD
• Tasha Marie Broach, APRN

  • Family Nurse Practitioner
  • Columbia, SC
  • NPI 1528446994
  Medicare reassignment NPD
• Shalanda Pollins, FNP

  • Family Nurse Practitioner
  • Columbia, SC
  • NPI 1093418683
  Medicare reassignment NPD

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

{
    "created_epoch": "1644451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644451200000",
    "number": "1912651647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3202 W FOREST LAKE DR",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295018267",
            "telephone_number": "843-992-7604",
            "fax_number": "843-799-4784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601A W LUCAS ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295011225",
            "telephone_number": "843-992-7604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONE SOURCE INTEGRATIVE MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-10",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-992-7604",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1578993820",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Saquisha Monique Oliver
• Anil Om, M.D.
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• Physical Medicine & Rehabilitation Physician in Florence, SC
• Providers in Florence, SC by specialty
• Physical Medicine & Rehabilitation Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.