Individual provider Active NPI

Michael Wayne Chandler, D.C.

  • Chiropractor
  • Cornelius, NC
National Provider Identifier
1023122496
Registry record updated Jan 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2373 Issued in NC
Practice address
19824 W Catawba Ave Ste E
Cornelius, NC 28031-4046
Phone
(704) 655-8930
Fax
(704) 655-8932
NPI assigned
Aug 19, 2006
Last updated
Jan 20, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2373 NC Primary

Addresses

Primary practice location

19824 W Catawba Ave Ste E
Cornelius, NC 28031-4046

Mailing address

PO Box 2487
Cornelius, NC 28031-2487
Phone (704) 655-8930

Other identifiers 1

IdentifierTypeStateIssuer
89085N9MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2373NCMDChiropractor

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263945600000",
    "number": "1023122496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2487",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280312487",
            "telephone_number": "704-655-8930",
            "fax_number": "704-655-8932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19824 W CATAWBA AVE STE E",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280314046",
            "telephone_number": "704-655-8930",
            "fax_number": "704-655-8932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANDLER",
        "first_name": "MICHAEL",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2010-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89085N9",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cornelius, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2010; 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.