NPIMap

Organization Active NPI

West Ashley Wellness & Rehabilitation, LLC

  • Rehabilitation Practitioner
  • Charleston, SC
National Provider Identifier
1962726117
Registry record updated Feb 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
License
23765 Issued in SC
Legal business name
WEST ASHLEY WELLNESS & REHABILITATION, LLC
Practice address
2 Carriage LN
Charleston, SC 29407-6010
Phone
(843) 571-3100
Fax
(843) 766-7798
NPI assigned
Mar 17, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2015

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

Authorized official

Name
Karen R Luckie
Title
Office Manager
Phone
(843) 571-3100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NR0400X 2265 SC
Rehabilitation PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 225400000X 23765 SC Primary

Addresses

Primary practice location

2 Carriage LN
Charleston, SC 29407-6010

Mailing address

2 Carriage LN
Charleston, SC 29407-6010
Phone (843) 571-3100

Other identifiers 2

IdentifierTypeStateIssuer
1083641914OtherSCINDIVIDUAL NPI
1427030212OtherSCINDIVIDUAL NPI

National Provider Directory

National Provider Directory

Locations

1694 Old Towne Rd
Charleston, SC 29407
Phone (843) 571-3100

110 N Memorial Ave
#B
Walterboro, SC 29488
Phone (843) 782-4111

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1268784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423526400000",
    "number": "1962726117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CARRIAGE LN",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294076010",
            "telephone_number": "843-571-3100",
            "fax_number": "843-766-7798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CARRIAGE LN",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294076010",
            "telephone_number": "843-571-3100",
            "fax_number": "843-766-7798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST ASHLEY WELLNESS & REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-17",
        "last_updated": "2015-02-10",
        "status": "A",
        "authorized_official_last_name": "LUCKIE",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "843-571-3100"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "SC",
            "license": "2265",
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Rehabilitation Practitioner",
            "state": "SC",
            "license": "23765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1083641914",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1427030212",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.