Individual provider Active NPI

Tina Marie Driscoll, D.C.

  • Chiropractor
  • Spring Lake, NC
National Provider Identifier
1083611040
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1830 Issued in NC
Practice address
1171 N Bragg Blvd
Spring Lake, NC 28390-3116
Phone
(910) 436-5000
Fax
(910) 436-7705
NPI assigned
Jul 6, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1830 NC Primary

Addresses

Primary practice location

1171 N Bragg Blvd
Spring Lake, NC 28390-3116

Mailing address

508 Glenola St
Fayetteville, NC 28311-3206
Phone (910) 822-3221

Other identifiers 2

IdentifierTypeStateIssuer
89085GRMedicaidNC
013FCOtherNCBCBS PROVIDER NO.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111128000785 NC Practitioner - Chiropractic 6002089380 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1171 N Bragg Blvd
Spring Lake Chiro
Spring Lake, NC 28390-3116
Phone (910) 436-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1830NCMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Health & Wellness Center, Inc. Chiropractor CurrentSince Jan 30, 2002 Accepting new patients

Locations

1171 N Bragg Blvd
Spring Lake, NC 28390
Phone (910) 436-5000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1120608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1083611040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 GLENOLA ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283113206",
            "telephone_number": "910-822-3221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1171 N BRAGG BLVD",
            "city": "SPRING LAKE",
            "state": "NC",
            "postal_code": "283903116",
            "telephone_number": "910-436-5000",
            "fax_number": "910-436-7705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRISCOLL",
        "first_name": "TINA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-06",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "1830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89085GR",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NO.",
            "identifier": "013FC",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Lake, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.