NPI Code Detail JSON Logo

1841656527 NPI number — CHUCKY SENTELL JORDAN D.C.

NPI Number: 1841656527
Health Care Provider/Practitioner: CHUCKY SENTELL JORDAN D.C.

Information about “1841656527” NPI (CHUCKY SENTELL JORDAN D.C.) exists in 1841656527 in HTML format HTML  |  1841656527 in plain Text format TXT  |  1841656527 in PDF (Portable Document Format) PDF  |  1841656527 in an XML format XML  formats.

NPI Number : 1841656527 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1841656527",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "JORDAN",
    "FirstName": "CHUCKY",
    "MiddleName": "SENTELL",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "D.C.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "542 BEN GAUSE RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "COWARD",
    "MailingAddressStateName": "SC",
    "MailingAddressPostalCode": "29530-5127",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "843-940-0687",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "263 KELLEY ST STE 100",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LAKE CITY",
    "PracticeLocationAddressStateName": "SC",
    "PracticeLocationAddressPostalCode": "29560-2472",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "843-394-8274",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "01/11/2016",
    "LastUpdateDate": "01/11/2016",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "111N00000X",
        "TaxonomyName": "Chiropractor",
        "LicenseNumber": "SC 4099",
        "LicenseNumberStateCode": "SC",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.