ADVANCED MEDICAL ASSOCIATES OF SUMMERVILLE (NPI# 1790748150) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790748150 |
| Entity Type | Organization |
| Organization Name | ADVANCED MEDICAL ASSOCIATES OF SUMMERVILLE |
| Practice Address |
1711 N Main St Summerville SC 29483-7807 |
| Practice Telephone | 8438752268 |
| Practice Fax Number | 8438752267 |
| Mailing Telephone | 8438752268 |
| Mailing Fax Number | 8438752267 |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2007-08-03 |
| Authorized Official Name | JON LLOYD ETHERIDGE (PRESIDENT) |
| Authorized Official Telephone | 8438752268 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208D00000X | General Practice | 15987 | SC | Allopathic & Osteopathic Physicians |
| N | 225100000X | Physical Therapist | 5123 | SC | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 111N00000X | Chiropractor | 1243 | SC | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | CDS | 2015987 | 01 |
| SC | GP4385 | 05 | |
| DEA | BS9223796 | 01 | |
| SC | CH1243 | 05 |
| Street Address |
1711 N MAIN ST |
| City | SUMMERVILLE |
| State | SC |
| Zip Code | 29483-7807 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043274707 | Jon Lloyd Etheridge | Chiropractor | 1711 N Main St, Summerville, SC 29483-7807 | 2006-04-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437764347 | Catherine M Bixler | Counselor | 314 W 4th St N, Summerville, SC 29483 | 2020-09-09 |
| 1255979431 | Jeanette Louise Virden | Counselor | 200 E 5th North Street, Summerville, SC 29483 | 2019-12-18 |
| 1912477415 | Kaylee Lobo | Nurse Practitioner | 203 Pavilion Street, Summerville, SC 29483 | 2018-11-28 |
| 1962981142 | Jackson Pediatric Dentistry of Summerville | Dentist | 405 West 4th Street North, Summerville, SC 29483 | 2018-08-09 |
| 1558885483 | Allied Medical Respiratory | Durable Medical Equipment & Medical Supplies | 200 W 5th North Street, Summerville, SC 29483 | 2017-08-02 |
| 1336671296 | Natalie M Clark | Specialist/Technologist | 102 Green Wave Boulevard, Dorchester School District Two, Summerville, SC 29483 | 2017-03-30 |
| 1649701897 | Usv Optical Inc. | Technician/Technologist | 1035 Jockey Ct., Summerville, SC 29483 | 2017-03-21 |
| 1497113617 | Roper Saint Francis Physicians Network | Surgery | 1112 N Main St Ste C, Summerville, SC 29483 | 2016-02-02 |
| 1083000798 | Andrea Sartori | Clinical Neuropsychologist | 107 W 5th North St Ste 102, Summerville, SC 29483 | 2015-04-09 |
| 1376931626 | Wendy Davis-jones | Home Health Aide | 203 Lakepointe Ave, Summerville, SC 29483 | 2015-01-08 |
| Find all providers in zip 29483 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841824851 | Whiplash Pain Center | Chiropractor | 907 Miles Jamison Rd Ste 4, Summerville, SC 29485-8705 | 2020-02-28 |
| 1063052082 | Julia Christine Hartman | Chiropractor | 607 W 5th North St, Summerville, SC 29483-6166 | 2020-01-07 |
| 1306356845 | Foundation Family Chiropractic | Chiropractor | 455 Old Trolley Rd Ste A, Summerville, SC 29485-5669 | 2017-10-11 |
| 1053862656 | Alexander Thomas Jr. | Chiropractor | 464 Azalea Square Blvd Unit D, Summerville, SC 29483-7335 | 2016-10-18 |
| 1013462837 | Kyle Thomas Heimer | Chiropractor | 1203 F Old Trolley Rd, Suite B, Summerville, SC 29485-5296 | 2016-08-22 |
| 1760894299 | April Rebecca Leary | Chiropractor | 1706 Old Trolley Rd, Suite F, Summerville, SC 29485-9035 | 2014-06-02 |
| 1538589585 | Gregory A Turpin | Chiropractor | 115 New Spring Ct, Summerville, SC 29485-5245 | 2014-04-17 |
| 1952650368 | Alignment Specific Chiropractic Clinic | Chiropractor | 606 Old Trolley Rd, Suite 102, Summerville, SC 29485 | 2012-08-30 |
| 1801153341 | Thomas A Taylor IIi | Chiropractor | 820 Central Ave Unit F, Summerville, SC 29483-3743 | 2012-04-23 |
| 1679852149 | Swain Chiropractic | Chiropractor | 931 Orangeburg Rd., Summerville, SC 29483 | 2011-08-15 |
| Find all providers in SUMMERVILLE | ||||
| City | SUMMERVILLE |
| Zip Code | 29483 |
Please comment or provide details below to improve the information on ADVANCED MEDICAL ASSOCIATES OF SUMMERVILLE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.