Active NPI
Wendy Renee Pavkov-Popow, D.C.
- Chiropractor
- Clinton, NC
National Provider Identifier
1033152806
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2885
- Practice address
- 401 Cooper Dr
Clinton, NC 28328-2817 - Phone
- (910) 592-2250
- NPI assigned
- Jun 13, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 | 2885 | NC | Primary |
Addresses
Primary practice location
401 Cooper Dr
Clinton, NC 28328-2817
Mailing address
216 Crossfire Rd
Holly Springs, NC 27540-8560
Phone (919) 577-3974
Other practice location 1
1100 Holly Springs Rd
Suite 100
Holly Springs, NC 27540-9469
Phone (919) 577-3974
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 89085J2 | Medicaid | NC | |
| 085J2 | Other | NC | BC/BS PROVIDER NUMBER |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sunset Ridge Chiropractic, PC | Chiropractor | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Chiropractor
- Holly Springs, NC
- NPI 1184720302
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1033152806",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "216 CROSSFIRE RD",
"city": "HOLLY SPRINGS",
"state": "NC",
"postal_code": "275408560",
"telephone_number": "919-577-3974",
"fax_number": "919-577-6351"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 COOPER DR",
"city": "CLINTON",
"state": "NC",
"postal_code": "283282817",
"telephone_number": "910-592-2250"
}
],
"practiceLocations": [
{
"address_1": "1100 Holly Springs Rd",
"address_2": "Suite 100",
"address_purpose": "LOCATION",
"city": "Holly Springs",
"state": "NC",
"postal_code": "275409469",
"country_code": "US",
"telephone_number": "919-577-3974",
"fax_number": "919-577-6351",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PAVKOV-POPOW",
"first_name": "WENDY",
"middle_name": "RENEE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-13",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NC",
"license": "2885",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "89085J2",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS PROVIDER NUMBER",
"identifier": "085J2",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clinton, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.