DR. CONNOR OWEN GLAZA DC
NPI 1205778339
Chiropractor in Lake Wylie, SC
About Dr. Connor Owen Glaza Dc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. CONNOR OWEN GLAZA DC (NPI 1205778339) is an individual chiropractor in Lake Wylie, South Carolina, licensed in South Carolina (5309) and active in the NPI registry since April 2026. He is a graduate of Sherman College Of Straight Chiropractic (2026).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Connor Owen Glaza Dc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Connor Glaza reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Lake Wylie, SC 29710
- Reassigned Medicare billing, South Carolina enrollment
- 2 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Connor Glaza's NPI number?
The NPI number for Connor Glaza is 1205778339. It was assigned to this individual provider in the NPPES registry on April 7, 2026.
Where is Connor Glaza located?
Connor Glaza practices at 548 Nautical Dr Ste 204, Lake Wylie, SC 29710. The listed phone number is (803) 831-2345.
What is Connor Glaza's specialty?
The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.
Is Connor Glaza enrolled in Medicare?
Yes. Connor Glaza is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Connor Glaza's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Connor Glaza reassigns Medicare benefits to Glaza Chiropractic Center, Inc (Lake Wylie, SC). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Connor Glaza's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Connor Glaza was last updated on April 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Connor Owen Glaza, DC · NPI 1205778339
Chiropractor provider in Lake Wylie, South Carolina. Individual provider, active in the CMS NPPES registry since April 7, 2026.
## Identity
- **NPI:** 1205778339 (Entity type: Individual)
- **Enumerated:** April 7, 2026
- **Primary specialty:** Chiropractor · taxonomy 111N00000X
- **State license:** 5309 (South Carolina)
- **Sole proprietor:** No
## Practice location
- **Address:** 548 NAUTICAL DR STE 204, Lake Wylie, SC 29710-0018
- **Phone:** (803) 831-2345
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Bills Medicare through:** Glaza Chiropractic Center, Inc (NPI 1679679971, Lake Wylie, SC), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Sherman College Of Straight Chiropractic, class of 2026
## Record status
- **NPPES last updated:** April 7, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1205778339) · Data from the CMS NPPES public registry.