Organization Active NPI

Vital Chiropractic Renewal

  • Chiropractor
  • Waynesville, NC
National Provider Identifier
1093454076
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
VITAL CHIROPRACTIC RENEWAL
Practice address
1101 N Main St
Waynesville, NC 28786-3593
Phone
(828) 200-2191
NPI assigned
May 31, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Authorized official

Name
Dakota Parris, DCNPI 1760072490
Title
Doctor of Chiropractic
Phone
(828) 736-0326

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

1101 N Main St
Waynesville, NC 28786-3593

Mailing address

342 Monteith Branch Rd
Sylva, NC 28779-9798
Phone (828) 200-2191

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220818003018 NC Part B Supplier - Clinic/Group Practice 5799168068 Receives reassigned benefits from 1 practitioner
Practice locations: Bryson City, NC

National Provider Directory

National Provider Directory

Locations

980 Main St
Bryson City, NC 28713
Phone (828) 200-2191

1101 N Main St
Waynesville, NC 28786
Phone (470) 344-4288

Practitioners & affiliated clinicians

Practitioners 1

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": "1653955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660176000000",
    "number": "1093454076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 MONTEITH BRANCH RD",
            "city": "SYLVA",
            "state": "NC",
            "postal_code": "287799798",
            "telephone_number": "828-200-2191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 N MAIN ST",
            "city": "WAYNESVILLE",
            "state": "NC",
            "postal_code": "287863593",
            "telephone_number": "828-200-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL CHIROPRACTIC RENEWAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-31",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-02",
        "status": "A",
        "authorized_official_last_name": "PARRIS",
        "authorized_official_first_name": "DAKOTA",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "828-736-0326",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waynesville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; 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.