Active NPI
Jonathan D Sisk, D.C.
- Chiropractor
- Blacksburg, SC
National Provider Identifier
1952632846
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3533
- Practice address
- 202 S Shelby St
Blacksburg, SC 29702-1542 - Phone
- (864) 839-2081
- Fax
- (866) 203-1019
- NPI assigned
- Jan 17, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 | 3533 | SC | Primary |
Addresses
Primary practice location
202 S Shelby St
Blacksburg, SC 29702-1542
Mailing address
202 S Shelby St
Blacksburg, SC 29702-1542
Phone (864) 839-2081
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629391230 | Other | SC | GROUP NPI FOR DR. JONATHAN SISK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110216001159 | SC | Practitioner - Chiropractic | 2567643018 | Practice locations: Blacksburg, SC |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Sherman College of Straight Chiropractic, 2009
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
202 S Shelby St
Blacksburg, SC 29702-1542
Phone (864) 839-2081
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3533 | SC | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344816000000",
"number": "1952632846",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "202 S SHELBY ST",
"city": "BLACKSBURG",
"state": "SC",
"postal_code": "297021542",
"telephone_number": "864-839-2081",
"fax_number": "864-839-2081"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "202 S SHELBY ST",
"city": "BLACKSBURG",
"state": "SC",
"postal_code": "297021542",
"telephone_number": "864-839-2081",
"fax_number": "866-203-1019"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SISK",
"first_name": "JONATHAN",
"middle_name": "D",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-01-17",
"last_updated": "2012-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "SC",
"license": "3533",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI FOR DR. JONATHAN SISK",
"identifier": "1629391230",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Blacksburg, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2012; 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.