Individual provider Active NPI

Luke Andrew Bennett, D.C.

  • Chiropractor
  • Charlotte, NC
National Provider Identifier
1104118488
Registry record updated Mar 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4183 Issued in NC
Practice address
201 McCullough Dr
Suite 160
Charlotte, NC 28262-3577
Phone
(304) 544-6548
NPI assigned
May 5, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4183 NC Primary

Addresses

Primary practice location

201 McCullough Dr
Suite 160
Charlotte, NC 28262-3577

Mailing address

201 McCullough Dr
Suite 160
Charlotte, NC 28262-3577
Phone (304) 544-6548

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111011000173 NC Practitioner - Chiropractic 7810169125 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9800 Kincey Ave
Suite 155
Huntersville, NC 28078-8415
Phone (704) 516-7394

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4183NCMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Topteam Fitness Academy, Inc. Chiropractor CurrentSince Apr 17, 2013 Accepting new patients
Luke a Bennett LLC Chiropractor PastSince Jul 19, 2011 Accepting new patients

Locations

201 McCullough Dr
Ste 160
Charlotte, NC 28262
Phone (304) 544-6548

9800 Kincey Ave
Ste 155
Huntersville, NC 28078
Phone (704) 516-7394

Organizations & group practices 2

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": "1304553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362182400000",
    "number": "1104118488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 MCCULLOUGH DR",
            "address_2": "SUITE 160",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282623577",
            "telephone_number": "304-544-6548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 MCCULLOUGH DR",
            "address_2": "SUITE 160",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282623577",
            "telephone_number": "304-544-6548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "LUKE",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-05",
        "last_updated": "2013-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "4183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2013; 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.