Cultivate Health Chiropractic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4060 Issued in SC

Legal business name

CULTIVATE HEALTH CHIROPRACTIC

Practice address

7580 Charlotte Hwy
Suite 800
Indian Land, SC 29707-7801

Phone

(803) 380-4310

Fax

(803) 380-4312

NPI assigned

Oct 5, 2015

Last updated

Oct 5, 2015By 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. Jessica Bradburn, DCNPI 1114397098

Title

Owner

Phone

(803) 380-4310

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Jessica Bradburn, DC

  • Chiropractor
  • Indian Land, SC
  • NPI 1114397098
  Authorized official Same address or phone

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

{
    "created_epoch": "1444003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444003200000",
    "number": "1932579810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7580 CHARLOTTE HWY",
            "address_2": "SUITE 800",
            "city": "INDIAN LAND",
            "state": "SC",
            "postal_code": "297077801",
            "telephone_number": "803-380-4310",
            "fax_number": "803-380-4312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7580 CHARLOTTE HWY",
            "address_2": "SUITE 800",
            "city": "INDIAN LAND",
            "state": "SC",
            "postal_code": "297077801",
            "telephone_number": "803-380-4310",
            "fax_number": "803-380-4312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CULTIVATE HEALTH CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-05",
        "last_updated": "2015-10-05",
        "status": "A",
        "authorized_official_last_name": "BRADBURN",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-380-4310",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "4060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.