Active NPI
Louis J Buffalino, DC
- Chiropractor
- Wilmington, NC
National Provider Identifier
1073629101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 909CHI
- Practice address
- 1133 Military Cutoff Rd
Ste 110
Wilmington, NC 28405-4403 - Phone
- (406) 222-4444
- Fax
- (406) 222-9796
- NPI assigned
- Aug 22, 2006
- Last updated
- Jul 13, 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 | 909CHI | MT | Primary |
Addresses
Primary practice location
1133 Military Cutoff Rd
Ste 110
Wilmington, NC 28405-4403
Mailing address
1133 Military Cutoff Rd
Ste 110
Wilmington, NC 28405-4403
Phone (406) 222-4444
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0164125 | Medicaid | MT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160815001110 | NC | Practitioner - Chiropractic | 7911058995 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4649 | NC | MD | Mental Health Counselor |
| 909CHI | MT | MD | Chiropractor |
| 909 | MT | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Revivify Chiropractic Wellness Center | Current | Accepting new patients | |
| Nohl P.C. | Past | Accepting new patients | |
| Ryan Herold P.C. | Chiropractor | Past | Accepting new patients |
Locations
3528 Adirondack Way
Ste 120
Wilmington, NC 28403
Phone (910) 679-4079
Organizations & group practices 4
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.
-
- Chiropractor
- Wilmington, NC
- NPI 1689112245
-
- Clinic/Center
- Wilmington, NC
- NPI 1992567424
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468368000000",
"number": "1073629101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1133 MILITARY CUTOFF RD",
"address_2": "STE 110",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284054403",
"telephone_number": "406-222-4444",
"fax_number": "406-222-9796"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1133 MILITARY CUTOFF RD",
"address_2": "STE 110",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284054403",
"telephone_number": "406-222-4444",
"fax_number": "406-222-9796"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUFFALINO",
"first_name": "LOUIS",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-22",
"last_updated": "2016-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MT",
"license": "909CHI",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0164125",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.