Organization Active NPI

Camel City Chiropractic PLLC

  • Chiropractor
  • Winston Salem, NC
National Provider Identifier
1114707577
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CAMEL CITY CHIROPRACTIC PLLC
Practice address
4622 Country Club Rd Ste 140
Winston Salem, NC 27104-3770
Phone
(336) 768-7227
Fax
(336) 768-3802
NPI assigned
Oct 3, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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

Authorized official

Name
Dr. Kevin M Sharp, DCNPI 1568458057
Title
Owner/Manager
Phone
(336) 768-7227

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 Primary

Addresses

Primary practice location

4622 Country Club Rd Ste 140
Winston Salem, NC 27104-3770

Mailing address

4622 Country Club Rd Ste 140
Winston Salem, NC 27104-3770
Phone (336) 768-7227

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231121001193 NC Part B Supplier - Clinic/Group Practice 9638527278 Receives reassigned benefits from 2 practitioners
Practice locations: Winston Salem, NC

National Provider Directory

National Provider Directory

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": "1696291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696291200000",
    "number": "1114707577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4622 COUNTRY CLUB RD STE 140",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271043770",
            "telephone_number": "336-768-7227",
            "fax_number": "336-768-3802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4622 COUNTRY CLUB RD STE 140",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271043770",
            "telephone_number": "336-768-7227",
            "fax_number": "336-768-3802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMEL CITY CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-03",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A",
        "authorized_official_last_name": "SHARP",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "336-768-7227",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; 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.