Active NPI
Carolina Forest Chiropractic, LLC
- Chiropractor
- Myrtle Beach, SC
National Provider Identifier
1932207305
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3616
- Legal business name
- CAROLINA FOREST CHIROPRACTIC, LLC
- Practice address
- 568 George Bishop Pkwy
Myrtle Beach, SC 29579-7339 - Phone
- (843) 236-2200
- NPI assigned
- Sep 20, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Ronald J. Pellicani, D.C.
- Title
- Owner
- Phone
- (843) 236-2200
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3616 | SC | Primary |
Addresses
Primary practice location
568 George Bishop Pkwy
Myrtle Beach, SC 29579-7339
Mailing address
4016 River Oaks Dr # 149
Myrtle Beach, SC 29579-6673
Phone (843) 236-2200
Other identifiers 17
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Y36167 | Other | MA | BC/BS OF MA |
| 351103 | Other | MA | HARVARD PILGRIM HEALTH |
| P-12032859 | Other | MA | MULTIPLAN |
| Y39207 | Other | MA | BLUE CROSS BLUE SHIELD MA |
| 0222552-01 | Other | MA | BMC HEALTHNET |
| B207689-01 | Other | MA | CIGNA |
| 001610 | Other | MA | TUFTS HEALTH PLAN |
| 42309 | Other | MA | FALLON COMMUNITY HEALTH P |
| 44-00274 | Other | MA | UNITED HEALTH CARE |
| 995969 | Other | MA | NETWORK HEALTH |
| 1003195 | Other | MA | AMERICAN SPECIALTY HEALTH |
| 04-3403673-00 | Other | MA | NEIGHBORHOOD HEALTH PLAN |
| 646792 | Other | MA | ACN GROUP |
| CH3616 | Medicaid | SC | |
| 04-3403673 | Other | MA | PRIVATE HEALTHCARE SYSTEM |
| 2114793 | Other | MA | AETNA |
| 1496056 | Other | MA | FIRST HEALTH |
Other names 1
- Davis Square Chiropractic, Inc.
National Provider Directory
National Provider DirectoryLocations
49 Holland St
Somerville, MA 02144
Phone (508) 455-7208
4016 River Oaks Dr
#149
Myrtle Beach, SC 29579
4036 River Oaks Dr
#B4
Myrtle Beach, SC 29579
Phone (843) 236-2200
Practitioners & affiliated clinicians
Practitioners 5
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.
-
- Chiropractor
- Myrtle Beach, SC
- NPI 1558462887
-
- Chiropractor
- Quincy, MA
- NPI 1194021790
-
- Chiropractor
- Sharon, MA
- NPI 1083910244
-
- Chiropractor
- Highlands Ranch, CO
- NPI 1053702696
-
- Chiropractor
- Somerville, MA
- NPI 1922281567
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1614297600000",
"number": "1932207305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4016 RIVER OAKS DR # 149",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295796673",
"telephone_number": "843-236-2200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "568 GEORGE BISHOP PKWY",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295797339",
"telephone_number": "843-236-2200"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CAROLINA FOREST CHIROPRACTIC, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-20",
"last_updated": "2021-02-26",
"certification_date": "2021-02-26",
"status": "A",
"authorized_official_last_name": "PELLICANI",
"authorized_official_first_name": "RONALD",
"authorized_official_middle_name": "J.",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "843-236-2200",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.C."
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Chiropractor",
"state": "SC",
"license": "3616",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS OF MA",
"identifier": "Y36167",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM HEALTH",
"identifier": "351103",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MULTIPLAN",
"identifier": "P-12032859",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD MA",
"identifier": "Y39207",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BMC HEALTHNET",
"identifier": "0222552-01",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "B207689-01",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS HEALTH PLAN",
"identifier": "001610",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FALLON COMMUNITY HEALTH P",
"identifier": "42309",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE",
"identifier": "44-00274",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NETWORK HEALTH",
"identifier": "995969",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN SPECIALTY HEALTH",
"identifier": "1003195",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEIGHBORHOOD HEALTH PLAN",
"identifier": "04-3403673-00",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ACN GROUP",
"identifier": "646792",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "CH3616",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRIVATE HEALTHCARE SYSTEM",
"identifier": "04-3403673",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "2114793",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "1496056",
"state": "MA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Davis Square Chiropractic, Inc.",
"code": "4",
"type": "Former Legal Business Name"
}
]
}Other providers in Myrtle Beach, SC
- Debra Anne Carnosso, LCSW-R AND LISW-CP
- Carolina Bone & Joint Surgery Center
- Carolina Clinic of Chiropractic, LLC
- Carolina Coastal Family Medicine PA
- Carolina Coastal Plastic and Reconstructive Surgery, Inc.
- Carolina Forest Family Eyecare, P.a.
- Carolina Forest Family Medicine
- Carolina Forest Hearing Center of SC LLC
- Carolina Forest Hearing Center, P.C.
- Carolina Forest Imaging Center LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.