NPIMap

Organization Active NPI

Harrisburg Chiropractic Clinic, Inc.

  • Chiropractor
  • Harrisburg, NC
National Provider Identifier
1124060686
Registry record updated Dec 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
200001183349 Issued in NC
Legal business name
HARRISBURG CHIROPRACTIC CLINIC, INC.
Practice address
12020 University City Blvd
Harrisburg, NC 28075-8466
Phone
(704) 455-2211
Fax
(704) 455-8246
NPI assigned
Jun 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2009

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

Authorized official

Name
Dr. Andrew Segarra, DCNPI 1770577546
Title
President
Phone
(704) 455-2211

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 200001183349 NC Primary

Addresses

Primary practice location

12020 University City Blvd
Harrisburg, NC 28075-8466

Mailing address

12020 University City Blvd
Harrisburg, NC 28075-8466
Phone (704) 455-2211

Other identifiers 2

IdentifierTypeStateIssuer
085AGOtherNCBLUE CROSS BLUE SHIELD NC
89085AGMedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050622001154 NC Part B Supplier - Clinic/Group Practice 5496790230 Receives reassigned benefits from 1 practitioner
Practice locations: Harrisburg, NC

National Provider Directory

National Provider Directory

Locations

12020 University City Blvd
Harrisburg, NC 28075
Phone (704) 455-2211

Practitioners & affiliated clinicians

Practitioners 1

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": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261180800000",
    "number": "1124060686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12020 UNIVERSITY CITY BLVD",
            "city": "HARRISBURG",
            "state": "NC",
            "postal_code": "280758466",
            "telephone_number": "704-455-2211",
            "fax_number": "704-455-8246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12020 UNIVERSITY CITY BLVD",
            "city": "HARRISBURG",
            "state": "NC",
            "postal_code": "280758466",
            "telephone_number": "704-455-2211",
            "fax_number": "704-455-8246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARRISBURG CHIROPRACTIC CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2009-12-19",
        "status": "A",
        "authorized_official_last_name": "SEGARRA",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-455-2211",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "200001183349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD NC",
            "identifier": "085AG",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89085AG",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2009; 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.