Individual provider Active NPI

Jesse Perseghin, D.C.

  • Chiropractor
  • Mount Pleasant, SC
National Provider Identifier
1972059004
Registry record updated Dec 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4313 Issued in SC
Practice address
1300 Hospital Dr Ste 220
Mount Pleasant, SC 29464-3208
Phone
(843) 936-6238
Fax
(843) 936-6239
NPI assigned
Aug 29, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH11877 FL
Chiropractor 111N00000X 4313 SC Primary

Addresses

Primary practice location

1300 Hospital Dr Ste 220
Mount Pleasant, SC 29464-3208

Mailing address

1300 Hospital Dr Ste 220
Mount Pleasant, SC 29464-3208
Phone (843) 936-6238

Other practice location 1

2447 Mill Creek Ct Ste 1
Tallahassee, FL 32308-8301
Phone (850) 325-6468 ext. 56468

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180515001663 SC Practitioner - Chiropractic 6507120706 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Real Healthcare Clinic LLCGroup PAC ID 2769825652, 2 clinicians

Practice addresses (Care Compare)

101 Springhall Dr
Goose Creek, SC 29445-5336
Phone (843) 302-0920

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH11877FLMDChiropractor
4313SCMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Real Healthcare Clinic LLC CurrentSince Jan 24, 2024 Accepting new patients
Smith Family Chiropractic Chiropractor Past Accepting new patients

Locations

101 Springhall Dr
Goose Creek, SC 29445
Phone (843) 302-0920

Interoperability endpoints

  • Direct secure messaging: jesse.perseghin.1@31845.direct.athenahealth.com

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1472428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576800000000",
    "number": "1972059004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 HOSPITAL DR STE 220",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294643208",
            "telephone_number": "843-936-6238",
            "fax_number": "843-936-6239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 HOSPITAL DR STE 220",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294643208",
            "telephone_number": "843-936-6238",
            "fax_number": "843-936-6239"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2447 Mill Creek Ct Ste 1",
            "address_purpose": "LOCATION",
            "city": "Tallahassee",
            "state": "FL",
            "postal_code": "323088301",
            "country_code": "US",
            "telephone_number": "850-325-6468 x56468",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERSEGHIN",
        "first_name": "JESSE",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-29",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH11877",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "4313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2019; 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.