DR. DONIVOL TARRELL BLUE (NPI# 1275807471) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275807471 |
| Entity Type | Individual |
| Full Name | DR. DONIVOL TARRELL BLUE |
| Credential | D.C. |
| Practice Address |
3079 Highway 701 N Ste A Conway SC 29526-3855 |
| Practice Telephone | 8433691831 |
| Mailing Telephone | 8433691831 |
| Enumeration Date | 2012-03-06 |
| Last Update Date | 2019-04-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111NT0100X |
Chiropractor Specialization: Thermography |
4120 | SC | Chiropractic Providers |
| Street Address |
3079 HIGHWAY 701 N STE A |
| City | CONWAY |
| State | SC |
| Zip Code | 29526-3855 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457975237 | Terri L Champion | Massage Therapist | 172 Waccamaw Medical Park Court, Conway, SC 29526 | 2020-06-08 |
| 1689204398 | Alayna Defalco | Clinical Exercise Physiologist | 1320 501 Business, Unit E, Conway, SC 29526 | 2020-01-22 |
| 1124672662 | Proxsys Rx - Sc, LLC | Pharmacy | 300 Singelton Ridge Road, Conway, SC 29526 | 2019-08-01 |
| 1598227431 | Surgery Center of Conway Inc | Clinic/Center | 1405 Main Street, Conway, SC 29526 | 2019-04-01 |
| 1801374962 | Trevor James Hess | Specialist/Technologist | 905 One Landon Loop, Conway, SC 29526 | 2018-08-01 |
| 1851800817 | Katherine Ann Nimphius | Behavioral Analyst | 105 Timberline Dr, Conway, SC 29526 | 2017-09-21 |
| 1922544253 | William Houck | Specialist/Technologist | 925 One Landon Loop, Conway, SC 29526 | 2017-01-10 |
| 1952857278 | Courtney Jeanette Smith | Counselor | 164 Waccamaw Medical Park Dr., Conway, SC 29526 | 2016-08-28 |
| 1336502632 | Jebediah S. Christy, D.d.s - Conway, Pllc | Dentist | 2756 Church St, Conway, SC 29526 | 2016-04-04 |
| 1447615208 | Abl Enterprises, LLC | Optometrist | 113 Citadel Drive, Conway, SC 29526 | 2015-12-22 |
| Find all providers in zip 29526 | ||||
| Taxonomy Code | 111NT0100X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| Specialization | Thermography |
| Definition to come... |
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| 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.