Thomas Kervin Andersen II, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5191 Issued in NC

Practice address

4517 Lead Mine Rd
Raleigh, NC 27612-3326

Phone

(919) 781-8830

Fax

(919) 781-1678

NPI assigned

Jul 29, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Group practices

Crabtree Chiropractic Center, PAGroup PAC ID 9931151644, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Crabtree Chiropractic Center, PA

  • Chiropractor
  • Raleigh, NC
  • NPI 1114946332
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1595980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595980800000",
    "number": "1114536869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4517 LEAD MINE RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276123326",
            "telephone_number": "919-781-8830",
            "fax_number": "919-781-1678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4517 LEAD MINE RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276123326",
            "telephone_number": "919-781-8830",
            "fax_number": "919-781-1678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSEN",
        "first_name": "THOMAS",
        "middle_name": "KERVIN",
        "name_suffix": "II",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-29",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "5191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ancient Path Farms LLC
• Allison Ancona, N.P-C
• Sianta Lonese Anderon
• Elizabeth Grace Andersen, PHARMD, RPH
• Lisa Ann Andersen, DO
• Alexandria Anderson, PHARMD
• Ashley Hagwood Anderson, WHNP
• Autumn Noel Anderson
• Brittany Anderson
• Brooke Anderson

• Chiropractor in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Chiropractor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2020; 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.