NPIMap

Organization Active NPI

Staker Chiropractic Center, P.C.

  • Chiropractor
  • Cary, NC
National Provider Identifier
1013015130
Registry record updated Jan 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2354 Issued in NC
Legal business name
STAKER CHIROPRACTIC CENTER, P.C.
Practice address
3550 NW Cary Pkwy
Suite 104
Cary, NC 27513-7409
Phone
(919) 460-1515
Fax
(919) 460-1979
NPI assigned
Sep 20, 2006
Last updated
Jan 27, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Michael Todd Staker, D.C.NPI 1083718555
Title
President
Phone
(919) 460-1515

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 2354 NC Primary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 2936 NC

Addresses

Primary practice location

3550 NW Cary Pkwy
Suite 104
Cary, NC 27513-7409

Mailing address

3550 NW Cary Pkwy
Suite 104
Cary, NC 27513-7409
Phone (919) 460-1515

Other identifiers 3

IdentifierTypeStateIssuer
01211OtherNCBCBS
085CNOtherNCBCBS
8901211MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080404000575 NC Part B Supplier - Clinic/Group Practice 6103909361 Receives reassigned benefits from 3 practitioners
Practice locations: Cary, NC

National Provider Directory

National Provider Directory

Locations

916 N E Maynard Rd
Cary, NC 27513
Phone (919) 460-1515

3550 NW Cary Pkwy
Ste 104
Cary, NC 27513
Phone (919) 460-1515

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296086400000",
    "number": "1013015130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3550 NW CARY PKWY",
            "address_2": "SUITE 104",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275137409",
            "telephone_number": "919-460-1515",
            "fax_number": "919-460-1979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 NW CARY PKWY",
            "address_2": "SUITE 104",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275137409",
            "telephone_number": "919-460-1515",
            "fax_number": "919-460-1979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAKER CHIROPRACTIC CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2011-01-27",
        "status": "A",
        "authorized_official_last_name": "STAKER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "TODD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-460-1515",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2354",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2936",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01211",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "085CN",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8901211",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.