NPIMap

Organization Active NPI

North Myrtle Beach Chiropractic PC

  • Chiropractor
  • North Myrtle Beach, SC
National Provider Identifier
1962588798
Registry record updated Oct 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1652 Issued in SC
Legal business name
NORTH MYRTLE BEACH CHIROPRACTIC PC
Practice address
513 Highway 17 N
North Myrtle Beach, SC 29582-2903
Phone
(843) 280-7000
Fax
(843) 280-7001
NPI assigned
Oct 27, 2006
Last updated
Oct 14, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2011

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

Authorized official

Name
Kevin M. Walter, D.C.
Title
Doctor of Chiropractic
Phone
(843) 280-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 1652 SC Primary

Addresses

Primary practice location

513 Highway 17 N
North Myrtle Beach, SC 29582-2903

Mailing address

513 Highway 17 N
North Myrtle Beach, SC 29582-2903
Phone (843) 280-7000

Other identifiers 2

IdentifierTypeStateIssuer
89085MRMedicaidNC
CH1652MedicaidSC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318550400000",
    "number": "1962588798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 HIGHWAY 17 N",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295822903",
            "telephone_number": "843-280-7000",
            "fax_number": "843-280-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 HIGHWAY 17 N",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295822903",
            "telephone_number": "843-280-7000",
            "fax_number": "843-280-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH MYRTLE BEACH CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2011-10-14",
        "status": "A",
        "authorized_official_last_name": "WALTER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "843-280-7000",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "1652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89085MR",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CH1652",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2011; 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.