Conway Chiropractic Center PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1407 Issued in SC

Legal business name

CONWAY CHIROPRACTIC CENTER PC

Practice address

1238 Pine St
Conway, SC 29526-3402

Phone

(843) 248-5814

Fax

(843) 248-0116

NPI assigned

May 4, 2006

Last updated

Jun 12, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Gaylord Lee Kelley Jr., DCNPI 1407815459

Title

Chiropractor

Phone

(843) 248-5814

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 1

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.

• Gaylord Lee Kelley Jr., DC

  • Chiropractor
  • Conway, SC
  • NPI 1407815459
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339459200000",
    "number": "1982652681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1238 PINE ST",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295263402",
            "telephone_number": "843-248-5814",
            "fax_number": "843-248-0116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1238 PINE ST",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295263402",
            "telephone_number": "843-248-5814",
            "fax_number": "843-248-0116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONWAY CHIROPRACTIC CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "last_updated": "2012-06-12",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "GAYLORD",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "843-248-5814",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "1407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Conway Adult Day Care
• Conway Adult Day Care at Creel St.
• Conway Adult Medicine
• Conway Anesthesia Associates
• Conway Anesthesia Services Inc
• Conway Family Dentistry, LLC (Conway Family Dentistry)
• Conway Health Care LLC
• Conway Hospital Aps
• Conway Hospital Community Services (CPG Women's Health)
• Conway Hospital Community Services (Horry Medical Associates)

• Chiropractor in Conway, SC
• Providers in Conway, SC by specialty
• Chiropractor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.