Organization Active NPI

Gorlesky Back & Neck Chiropractic, Inc

  • Clinic/Center
  • Wake Forest, NC
National Provider Identifier
1013086909
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
1030 Issued in NC
Legal business name
GORLESKY BACK & NECK CHIROPRACTIC, INC
Practice address
301 S White St
Wake Forest, NC 27587-2916
Phone
(919) 556-1033
Fax
(919) 556-1034
NPI assigned
Nov 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jack Gorlesky, DC
Title
Owner
Phone
(919) 556-1033

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 1030 NC Primary

Addresses

Primary practice location

301 S White St
Wake Forest, NC 27587-2916

Mailing address

301 S White St
Wake Forest, NC 27587-2916
Phone (919) 556-1033

Other identifiers 1

IdentifierTypeStateIssuer
08452OtherNCBLUE CROSS-BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

301 S White St
Wake Forest, NC 27587
Phone (919) 556-1033

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013086909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S WHITE ST",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275872916",
            "telephone_number": "919-556-1033",
            "fax_number": "919-556-1034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S WHITE ST",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275872916",
            "telephone_number": "919-556-1033",
            "fax_number": "919-556-1034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GORLESKY BACK & NECK CHIROPRACTIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GORLESKY",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-556-1033",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NC",
            "license": "1030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS-BLUE SHIELD",
            "identifier": "08452",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wake Forest, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.