Individual provider Active NPI

David R Friedman, DC

  • Chiropractor
  • Wilmington, NC
National Provider Identifier
1104849306
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
NC1774 Issued in NC
Practice address
1033 S Kerr Ave
Wilmington, NC 28403-4312
Phone
(910) 350-2664
Fax
(910) 350-0632
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NC1774 NC Primary

Addresses

Primary practice location

1033 S Kerr Ave
Wilmington, NC 28403-4312

Mailing address

1033 S Kerr Ave
Wilmington, NC 28403-4312
Phone (910) 350-2664

Other identifiers 3

IdentifierTypeStateIssuer
0824XOtherNCBCBS
890824XMedicaidNC
330587OtherNCACN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100918000163 NC Practitioner - Chiropractic 6305961012 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
David R. Friedman DC PAGroup PAC ID 3072638782, 2 clinicians

Practice addresses (Care Compare)

1033 S Kerr Ave
Wilmington, NC 28403-4312
Phone (910) 350-2664

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NC1774NCMDChiropractor
1774NCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
David R. Friedman DC PA Chiropractor CurrentSince Jul 6, 1992 Accepting new patients

Locations

1033 S Kerr Ave
Wilmington, NC 28403
Phone (910) 350-2664

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104849306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1033 S KERR AVE",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284034312",
            "telephone_number": "910-350-2664",
            "fax_number": "910-350-0632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1033 S KERR AVE",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284034312",
            "telephone_number": "910-350-2664",
            "fax_number": "910-350-0632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDMAN",
        "first_name": "DAVID",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "NC1774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0824X",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890824X",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN",
            "identifier": "330587",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.