Advanced Medical Associates Of Summerville
Chiropractor in Summerville, SC. Organization (NPI-2).
NPI number1790748150
StatusActive
Last updated in NPPESMar 7, 2023
Details
- NPI
- 1790748150
- Entity type
- Organization (NPI-2)
- Legal business name
- Advanced Medical Associates Of Summerville
- Organization subpart
- No
- Enumeration date
- Apr 7, 2006
- Last updated
- Mar 7, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 111N00000X | Chiropractor | 1243 | SC | Yes |
| 208D00000X | General Practice | 15987 | SC | |
| 225100000X | Physical Therapist | 5123 | SC |
Practice location
1711 N Main StSummerville, SC 29483-7807
Phone 843-875-2268 · Fax 843-875-2267
Mailing address
1711 N Main StSummerville, SC 29483-7807
Phone 843-875-2268 · Fax 843-875-2267
Authorized official
Jon Lloyd Etheridge
President
8438752268
Is something wrong?
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