Individual provider Active NPI

Michael Todd Staker, DC

  • Chiropractor
  • Cary, NC
National Provider Identifier
1083718555
Registry record updated Sep 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2354 Issued in NC
Practice address
3550 NW Cary Parkway
Suite 104
Cary, NC 27513-7410
Phone
(919) 460-1515
Fax
(919) 460-1979
NPI assigned
Sep 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2354 NC Primary

Addresses

Primary practice location

3550 NW Cary Parkway
Suite 104
Cary, NC 27513-7410

Mailing address

3550 NW Cary Parkway
Suite 104
Cary, NC 27513-7410
Phone (919) 460-1515

Other identifiers 2

IdentifierTypeStateIssuer
01211OtherNCBCBS
8908815MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080404000545 NC Practitioner - Chiropractic 7911084611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Staker Chiropractic Center PCGroup PAC ID 6103909361, 3 clinicians

Practice addresses (Care Compare)

3550 N W Cary Pkwy
Suite 104
Cary, NC 27513-8444
Phone (919) 460-1515

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2354NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Staker Chiropractic Center, P.C. Chiropractor CurrentSince Jan 1, 2001 Accepting new patients

Locations

3550 NW Cary Pkwy
Ste 104
Cary, NC 27513
Phone (919) 460-1515

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, 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": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285804800000",
    "number": "1083718555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3550 NW CARY PARKWAY",
            "address_2": "SUITE 104",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275137410",
            "telephone_number": "919-460-1515",
            "fax_number": "919-460-1979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 NW CARY PARKWAY",
            "address_2": "SUITE 104",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275137410",
            "telephone_number": "919-460-1515",
            "fax_number": "919-460-1979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAKER",
        "first_name": "MICHAEL",
        "middle_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-12",
        "last_updated": "2010-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01211",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8908815",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2010; 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.