NPIMap

Organization Active NPI

Democko Chiropractic PLLC

  • Chiropractor
  • Goldsboro, NC
National Provider Identifier
1104987205
Registry record updated Feb 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2077 Issued in NC
Legal business name
DEMOCKO CHIROPRACTIC PLLC
Practice address
1802 E Ash St
Goldsboro, NC 27530-4045
Phone
(919) 735-2205
Fax
(919) 735-2045
NPI assigned
Dec 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2008

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

Authorized official

Name
Dr. Joseph W. Democko, D.C.NPI 1649241209
Title
Owner
Phone
(919) 735-2205

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 2077 NC Primary

Addresses

Primary practice location

1802 E Ash St
Goldsboro, NC 27530-4045

Mailing address

1802 E. Ash St.
Goldsboro, NC 27530
Phone (919) 735-2205

Other identifiers 4

IdentifierTypeStateIssuer
0914LOtherNCCNC PROVIDER NUMBER
890833AMedicaidNC
0833AOtherNCBCBS PROVIDER NUMBER
890837VMedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080311000379 NC Part B Supplier - Clinic/Group Practice 8426133794 Receives reassigned benefits from 4 practitioners
Practice locations: Goldsboro, NC

National Provider Directory

National Provider Directory

Locations

1802 E Ash St
Goldsboro, NC 27530
Phone (919) 735-2205

Practitioners & affiliated clinicians

Practitioners 4

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": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203984000000",
    "number": "1104987205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 E. ASH ST.",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "27530",
            "telephone_number": "919-735-2205",
            "fax_number": "919-735-2045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 E ASH ST",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275304045",
            "telephone_number": "919-735-2205",
            "fax_number": "919-735-2045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEMOCKO CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2008-02-26",
        "status": "A",
        "authorized_official_last_name": "DEMOCKO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-735-2205",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CNC PROVIDER NUMBER",
            "identifier": "0914L",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890833A",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "0833A",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890837V",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goldsboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2008; 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.