Individual provider Active NPI

Randall S. Adamson, DC

  • Chiropractor
  • Holly Springs, NC
National Provider Identifier
1063502391
Registry record updated Aug 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3160 Issued in NC
Practice address
125 Holly Springs Rd
Holly Springs, NC 27540-9423
Phone
(919) 552-8011
Fax
(919) 557-1285
NPI assigned
Oct 16, 2006
Last updated
Aug 4, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 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 3160 NC Primary

Addresses

Primary practice location

125 Holly Springs Rd
Holly Springs, NC 27540-9423

Mailing address

125 Holly Springs Rd
Holly Springs, NC 27540-9423
Phone (919) 552-8011

Other identifiers 1

IdentifierTypeStateIssuer
89085K2MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100828000167 NC Practitioner - Chiropractic 9830213784 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

125 Holly Springs Rd
Holly Springs, NC 27540-9423
Phone (919) 552-8011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3160NCMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Holly Springs Chiropractic PA CurrentSince Feb 14, 2003 Accepting new patients

Locations

125 Holly Springs Rd
Holly Springs, NC 27540
Phone (919) 552-8011

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, 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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280880000000",
    "number": "1063502391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 HOLLY SPRINGS RD",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275409423",
            "telephone_number": "919-552-8011",
            "fax_number": "919-557-1285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 HOLLY SPRINGS RD",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275409423",
            "telephone_number": "919-552-8011",
            "fax_number": "919-557-1285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMSON",
        "first_name": "RANDALL",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2010-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "3160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89085K2",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holly Springs, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2010; 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.