Organization Active NPI

City Chiropractic PLLC

  • Chiropractor
  • Charlotte, NC
National Provider Identifier
1144586272
Registry record updated Apr 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3936 Issued in NC
Legal business name
CITY CHIROPRACTIC PLLC
Practice address
14142 Rivergate Pkwy
Suite 300
Charlotte, NC 28273-8906
Phone
(704) 587-0078
Fax
(704) 587-0071
NPI assigned
Apr 3, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2012

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

Authorized official

Name
Dr. Jared Scott Scholtisek, D.C.NPI 1730320524
Title
President
Phone
(704) 587-0078

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 3936 NC Primary

Addresses

Primary practice location

14142 Rivergate Pkwy
Suite 300
Charlotte, NC 28273-8906

Mailing address

14142 Rivergate Pkwy
Suite 300
Charlotte, NC 28273-8906
Phone (704) 587-0078

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131004000338 NC Part B Supplier - Clinic/Group Practice 5092949057 Receives reassigned benefits from 2 practitioners
Practice locations: Charlotte, NC

National Provider Directory

National Provider Directory

Locations

14142 Rivergate Pkwy
Ste 300
Charlotte, NC 28273
Phone (704) 293-8280

Practitioners & affiliated clinicians

Practitioners 3

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": "1333411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333411200000",
    "number": "1144586272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14142 RIVERGATE PKWY",
            "address_2": "SUITE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282738906",
            "telephone_number": "704-587-0078",
            "fax_number": "704-587-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14142 RIVERGATE PKWY",
            "address_2": "SUITE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282738906",
            "telephone_number": "704-587-0078",
            "fax_number": "704-587-0071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-03",
        "last_updated": "2012-04-03",
        "status": "A",
        "authorized_official_last_name": "SCHOLTISEK",
        "authorized_official_first_name": "JARED",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-587-0078",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "3936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2012; 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.