Organization Active NPI

Chiropractic Physicians of the Carolinas

  • Chiropractor
  • Shelby, NC
National Provider Identifier
1073922159
Registry record updated Jan 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4192 Issued in NC
Legal business name
CHIROPRACTIC PHYSICIANS OF THE CAROLINAS
Practice address
513 S Dekalb St
Shelby, NC 28150-5926
Phone
(704) 406-9939
Fax
(704) 406-9940
NPI assigned
Aug 4, 2014
Last updated
Jan 16, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2015

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

Authorized official

Name
Dr. Heather Brooke Ellison, D.C.NPI 1487935094
Title
President
Phone
(704) 406-9939

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4192 NC Primary

Addresses

Primary practice location

513 S Dekalb St
Shelby, NC 28150-5926

Mailing address

513 S Dekalb St
Shelby, NC 28150-5926
Phone (704) 406-9939

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141110000593 NC Part B Supplier - Clinic/Group Practice 3678795580 Receives reassigned benefits from 1 practitioner
Practice locations: Shelby, NC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1407110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421366400000",
    "number": "1073922159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 S DEKALB ST",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281505926",
            "telephone_number": "704-406-9939",
            "fax_number": "704-406-9940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 S DEKALB ST",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281505926",
            "telephone_number": "704-406-9939",
            "fax_number": "704-406-9940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC PHYSICIANS OF THE CAROLINAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-04",
        "last_updated": "2015-01-16",
        "status": "A",
        "authorized_official_last_name": "ELLISON",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "BROOKE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-406-9939",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "4192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2015; 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.

Verify at the official NPI Registry.