Active NPI
Christopher R Ennis, D.C
- Chiropractor
- Winston Salem, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 4651
- Practice address
- 1515 Hanes Mall Blvd
Winston Salem, NC 27103-1358 - Phone
- (336) 773-7373
- NPI assigned
- Jul 28, 2016
- Last updated
- Jul 28, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 4651 | NC | Primary |
Addresses
Primary practice location
1515 Hanes Mall Blvd
Winston Salem, NC 27103-1358
Mailing address
1515 Hanes Mall Blvd
Winston Salem, NC 27103-1358
Phone (336) 773-7373
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 89016AP | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1515 Hanes Mall Blvd
Winston Salem, NC 27103-1358
Phone (336) 773-7373
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Keith Clinic Estramonte Chiropractic | Chiropractor | Current | Accepting new patients |
| Estramonte Chiropractic & Wellness Center East, P.a. | Chiropractor | Current | Accepting new patients |
| Estramonte Chiropractic West PA | Chiropractor | Current | Accepting new patients |
| Optimize Chiropractic, PLLC | Chiropractor | Current | Accepting new patients |
| Estramonte Chiropractic & Wellness Center | Chiropractor | Current | Accepting new patients |
| Gys Chiro Inc | Chiropractor | Past | Accepting new patients |
Locations
4016 Triangle Dr
Charlotte, NC 28208
Phone (704) 392-1338
402 E Sugar Creek Rd
Charlotte, NC 28213
Phone (704) 405-7000
5344 Central Ave
Charlotte, NC 28212
Phone (704) 568-4195
6859 South Blvd
Charlotte, NC 28217
Phone (704) 274-5477
19109 W Catawba Ave
Ste 100
Cornelius, NC 28031
Phone (248) 331-7950
Networks
- devoted network organization-92131eb0-09f2-4173-a140-cf7b381f0cf1
Organizations & group practices 7
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.
-
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469664000000",
"number": "1023561875",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1515 HANES MALL BLVD",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271031358",
"telephone_number": "336-773-7373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 HANES MALL BLVD",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271031358",
"telephone_number": "336-773-7373"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENNIS",
"first_name": "CHRISTOPHER",
"middle_name": "R",
"credential": "D.C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-07-28",
"last_updated": "2016-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NC",
"license": "4651",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "89016AP",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.