Individual provider Active NPI

Daniel John Culliton, D.C.

  • Chiropractor
  • Fayetteville, NC
National Provider Identifier
1053409649
Registry record updated Aug 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2863 Issued in NC
Practice address
3706 Morganton Rd
Fayetteville, NC 28303-4963
Phone
(910) 867-5500
Fax
(910) 867-4120
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2863 NC Primary

Addresses

Primary practice location

3706 Morganton Rd
Fayetteville, NC 28303-4963

Mailing address

3706 Morganton Rd
Fayetteville, NC 28303-4963
Phone (910) 867-5500

Other identifiers 5

IdentifierTypeStateIssuer
437501OtherNCWELLPATH ID
562239006OtherNCTAX ID
486753000OtherNCOWCP ID
0849YOtherNCBLUE CROSS ID
890849YMedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070310000041 NC Practitioner - Chiropractic 7214030337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Physical Medicine PAGroup PAC ID 0547554008, 2 clinicians

Practice addresses (Care Compare)

3706 Morganton Rd
Fayetteville, NC 28303-4963
Phone (910) 867-5500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2863NCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Physical Medicine PA CurrentSince May 8, 2017 Accepting new patients
Chiropractic Center of Solon, Inc. Chiropractor Past Accepting new patients

Locations

3706 Morganton Rd
Fayetteville, NC 28303
Phone (910) 867-5500

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346198400000",
    "number": "1053409649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3706 MORGANTON RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283034963",
            "telephone_number": "910-867-5500",
            "fax_number": "910-867-4120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3706 MORGANTON RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283034963",
            "telephone_number": "910-867-5500",
            "fax_number": "910-867-4120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULLITON",
        "first_name": "DANIEL",
        "middle_name": "JOHN",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2012-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLPATH ID",
            "identifier": "437501",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "562239006",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP ID",
            "identifier": "486753000",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS ID",
            "identifier": "0849Y",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890849Y",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; 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.

Verify at the official NPI Registry.