Individual provider Active NPI

Kristen Carroll Barenborg, DC

  • Chiropractor
  • Summerville, SC
National Provider Identifier
1962516393
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
SC 2030 Issued in SC
Practice address
209 W 6TH North St
Summerville, SC 29483-6616
Phone
(843) 875-3315
Fax
(843) 875-7266
NPI assigned
Aug 19, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X SC 2030 SC Primary

Addresses

Primary practice location

209 W 6TH North St
Summerville, SC 29483-6616

Mailing address

209 W 6TH North St
Summerville, SC 29483-6616
Phone (843) 875-3315

Other identifiers 1

IdentifierTypeStateIssuer
2030MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120112000328 SC Practitioner - Chiropractic 1759381668 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

209 W 6TH N St
Summerville, SC 29483-6616
Phone (843) 875-3315

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC 2030SCMDChiropractor
2030SCMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Barenborg Chiropractic Chiropractor CurrentSince Sep 3, 1998 Accepting new patients

Locations

209 W 6th North St
Summerville, SC 29483
Phone (843) 875-3315

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962516393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 W 6TH NORTH ST",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294836616",
            "telephone_number": "843-875-3315",
            "fax_number": "843-875-7266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 W 6TH NORTH ST",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294836616",
            "telephone_number": "843-875-3315",
            "fax_number": "843-875-7266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARENBORG",
        "first_name": "KRISTEN",
        "middle_name": "CARROLL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "SC 2030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2030",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.