Individual provider Active NPI

Tommie D Clewis, DC

  • Chiropractor
  • Pinehurst, NC
National Provider Identifier
1073500146
Registry record updated Dec 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1825 Issued in NC
Practice address
315 Page Rd N Ste 11
Pinehurst, NC 28374-0087
Phone
(910) 295-1215
Fax
(910) 295-1814
NPI assigned
Oct 4, 2005
Last updated
Dec 4, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1825 NC Primary

Addresses

Primary practice location

315 Page Rd N Ste 11
Pinehurst, NC 28374-0087

Mailing address

921 E Broad Ave
Rockingham, NC 28379-4338
Phone (910) 895-6042

Other identifiers 3

IdentifierTypeStateIssuer
0846HOtherNCBLUE CROSS/BLUE SHIELD
890846HMedicaidNC
FH7000200OtherNCFIRST CAROLINA CARE

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL https://www.pinehurstchiro.com/
Other URL https://www.pinehurstchiro.com/

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100421000235 NC Practitioner - Chiropractic 7214064369 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1990
Medicare assignment
May accept Medicare assignment
Group practices
Pinehurst Chiropractic IncGroup PAC ID 2860402781, 3 clinicians

Practice addresses (Care Compare)

315 Page Rd
Suite 11
Pinehurst, NC 28374-8751
Phone (910) 295-1215

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1825NCMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pinehurst Chiropractic Inc Chiropractor CurrentSince Mar 1, 2010 Accepting new patients

Locations

315 Page Rd N
Ste 11
Pinehurst, NC 28374
Phone (910) 295-1215

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": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575417600000",
    "number": "1073500146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 E BROAD AVE",
            "city": "ROCKINGHAM",
            "state": "NC",
            "postal_code": "283794338",
            "telephone_number": "910-895-6042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 PAGE RD N STE 11",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283740087",
            "telephone_number": "910-295-1215",
            "fax_number": "910-295-1814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEWIS",
        "first_name": "TOMMIE",
        "middle_name": "D",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2019-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "1825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "0846H",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890846H",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST CAROLINA CARE",
            "identifier": "FH7000200",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.pinehurstchiro.com/",
            "affiliation": "N",
            "endpointDescription": "Pinehurst Chiropractic Website",
            "address_1": "315 Page Rd N Ste 11",
            "city": "Pinehurst",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283740087",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.pinehurstchiro.com/",
            "affiliation": "N",
            "address_1": "315 Page Rd N Ste 11",
            "city": "Pinehurst",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283740087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pinehurst, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2019; 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.