NPIMap

Organization Active NPI

Colleton Chiropractic, LLC

  • Chiropractor
  • Walterboro, SC
National Provider Identifier
1992965503
Registry record updated Nov 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3350 Issued in SC
Legal business name
COLLETON CHIROPRACTIC, LLC
Practice address
211 Eddie Chasteen Drive
Walterboro, SC 29488
Phone
(843) 539-1111
Fax
(843) 782-4104
NPI assigned
Jun 17, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2018

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

Authorized official

Name
Dr. Brianne Krista Gallagher, DCNPI 1952324683
Title
Owner/Doctor
Phone
(843) 539-1111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 3350 SC Primary

Addresses

Primary practice location

211 Eddie Chasteen Drive
Walterboro, SC 29488

Mailing address

211 Eddie Chasteen Drive
Walterboro, SC 29488
Phone (843) 539-1111

Other practice location 1

4510 Jefferies Hwy
Walterboro, SC 29488-6489
Phone (843) 539-1111

Other names 1

  • Colleton County Chiropractic, LLC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080825000648 SC Part B Supplier - Clinic/Group Practice 0143395244 Receives reassigned benefits from 4 practitioners
Practice locations: Walterboro, SC

National Provider Directory

National Provider Directory

Locations

4510 Jefferies Hwy
Walterboro, SC 29488
Phone (843) 539-1111

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": "1213660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543276800000",
    "number": "1992965503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 EDDIE CHASTEEN DRIVE",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "29488",
            "telephone_number": "843-539-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 EDDIE CHASTEEN DRIVE",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "29488",
            "telephone_number": "843-539-1111",
            "fax_number": "843-782-4104"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4510 Jefferies Hwy",
            "address_purpose": "LOCATION",
            "city": "Walterboro",
            "state": "SC",
            "postal_code": "294886489",
            "country_code": "US",
            "telephone_number": "843-539-1111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COLLETON CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-17",
        "last_updated": "2018-11-27",
        "status": "A",
        "authorized_official_last_name": "GALLAGHER",
        "authorized_official_first_name": "BRIANNE",
        "authorized_official_middle_name": "KRISTA",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "843-539-1111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "3350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Colleton County Chiropractic, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Walterboro, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2018; 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.