Individual provider Active NPI

Christopher Dewaine Smith, DC

  • Chiropractor
  • Edenton, NC
National Provider Identifier
1073787206
Registry record updated Dec 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3848 Issued in NC
Practice address
300 Virginia Rd Ste D
Edenton, NC 27932-9553
Phone
(843) 697-8631
NPI assigned
Apr 18, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3848 NC Primary
Sports Physician Chiropractor 111NS0005X 2008-072716 SC

Addresses

Primary practice location

300 Virginia Rd Ste D
Edenton, NC 27932-9553

Mailing address

100 River Walk Dr
Simpsonville, SC 29681-5243
Phone (843) 697-8631

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090808000049 NC Practitioner - Chiropractic 8820160179 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Miller Chiropractic Group, PAGroup PAC ID 7214080258, 2 clinicians

Practice addresses (Care Compare)

300 Virginia Rd
Suite D
Edenton, NC 27932-9553
Phone (252) 482-4499

744 US Hwy 64 E
Plymouth, NC 27962-9313
Phone (252) 793-9600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2008-072716SCMDSports Physician Chiropractor
3848NCMDOccupational Therapy Assistant
3348SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Smith Chiropractic Group, PLLC Chiropractor CurrentSince Aug 7, 2021 Accepting new patients
Miller Chiropractic Group, PA Chiropractor CurrentSince Jul 1, 2009 Accepting new patients
Columbia Chiropractic Center PC Chiropractor PastSince Jul 1, 2009 Accepting new patients

Locations

300 Virginia Rd
Ste D
Edenton, NC 27932
Phone (252) 482-4499

744 US Highway 64 E
Plymouth, NC 27962
Phone (252) 793-9600

Organizations & group practices 3

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": "1208476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228867200000",
    "number": "1073787206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RIVER WALK DR",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296815243",
            "telephone_number": "843-697-8631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 VIRGINIA RD STE D",
            "city": "EDENTON",
            "state": "NC",
            "postal_code": "279329553",
            "telephone_number": "843-697-8631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHRISTOPHER",
        "middle_name": "DEWAINE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-18",
        "last_updated": "2008-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "3848",
            "primary": true
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "SC",
            "license": "2008-072716",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edenton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2008; 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.