Organization Active NPI

Porter & Rabinowitz Chiropractic, PLLC

  • Chiropractor
  • Wake Forest, NC
National Provider Identifier
1104003508
Registry record updated Aug 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3774 Issued in NC
Legal business name
PORTER & RABINOWITZ CHIROPRACTIC, PLLC
Practice address
12351 Capital Blvd
Wake Forest, NC 27587-7425
Phone
(919) 556-0282
NPI assigned
Jan 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2015

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

Authorized official

Name
Dr. Kelly E Porter, D.C.NPI 1598946220
Title
Owner/Chiropractor
Phone
(919) 556-0282

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 3773 NC
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 3774 NC Primary

Addresses

Primary practice location

12351 Capital Blvd
Wake Forest, NC 27587-7425

Mailing address

12351 Capital Blvd
Wake Forest, NC 27587-7425
Phone (919) 556-0282

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080226000448 NC Part B Supplier - Clinic/Group Practice 1850475187 Receives reassigned benefits from 2 practitioners
Practice locations: Wake Forest, NC

National Provider Directory

National Provider Directory

Locations

1002 Durham Rd
Ste 800
Wake Forest, NC 27587
Phone (919) 556-0282

12351 Capital Blvd
Wake Forest, NC 27587
Phone (919) 556-0282

Interoperability endpoints

  • Direct secure messaging: dradam@prc0001.direct.chirotouch.md
  • Direct secure messaging: kelly@prc0001.direct.chirotouch.md

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": "1201478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440979200000",
    "number": "1104003508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12351 CAPITAL BLVD",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275877425",
            "telephone_number": "919-556-0282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12351 CAPITAL BLVD",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275877425",
            "telephone_number": "919-556-0282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTER & RABINOWITZ CHIROPRACTIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-28",
        "last_updated": "2015-08-31",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "919-556-0282",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "3773",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "3774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wake Forest, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.