Organization Active NPI

Keith Clinic Estramonte Chiropractic Kings Mountain PA

  • Chiropractor
  • Kings Mountain, NC
National Provider Identifier
1083587000
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
KEITH CLINIC ESTRAMONTE CHIROPRACTIC KINGS MOUNTAIN PA
Practice address
510A W King St
Kings Mountain, NC 28086-3310
Phone
(980) 396-2811
NPI assigned
Sep 25, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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

Authorized official

Name
Debra Lee Hudson
Title
Senior Accounting Analyst
Phone
(704) 420-4690

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

510A W King St
Kings Mountain, NC 28086-3310

Mailing address

510A W King St Ste a
Kings Mountain, NC 28086-3310
Phone (980) 396-2811

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260218000610 NC Part B Supplier - Clinic/Group Practice 8426538489 Receives reassigned benefits from 1 practitioner
Practice locations: Kings Mountain, NC

National Provider Directory

National Provider Directory

Locations

510 W King St
#A
Kings Mountain, NC 28086
Phone (980) 396-2811

510A W King St
Kings Mountain, NC 28086
Phone (980) 396-2811

510A W King St
Ste A
Kings Mountain, NC 28086

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1758758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765756800000",
    "number": "1083587000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510A W KING ST STE A",
            "city": "KINGS MOUNTAIN",
            "state": "NC",
            "postal_code": "280863310",
            "telephone_number": "980-396-2811",
            "fax_number": "980-221-1654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510A W KING ST",
            "city": "KINGS MOUNTAIN",
            "state": "NC",
            "postal_code": "280863310",
            "telephone_number": "980-396-2811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEITH CLINIC ESTRAMONTE CHIROPRACTIC KINGS MOUNTAIN PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-25",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A",
        "authorized_official_last_name": "HUDSON",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "SENIOR ACCOUNTING ANALYST",
        "authorized_official_telephone_number": "704-420-4690"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kings Mountain, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2025; 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.