Individual provider Active NPI

Thomas Jason Permenter, DC

  • Chiropractor
  • Charlotte, NC
National Provider Identifier
1164422192
Registry record updated Jan 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2671 Issued in NC
Practice address
9123 Monroe Rd Ste 100
Charlotte, NC 28270-2456
Phone
(704) 569-3130
Fax
(704) 569-9797
NPI assigned
Aug 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2671 NC Primary

Addresses

Primary practice location

9123 Monroe Rd Ste 100
Charlotte, NC 28270-2456

Mailing address

9123 Monroe Rd Ste 100
Charlotte, NC 28270-2456
Phone (704) 569-3130

Other identifiers 10

IdentifierTypeStateIssuer
7572054OtherNCAETNA - PPO
790838FMedicaidNC
0838FOtherNCBCBS
606834-980061OtherNCACN
NC3802OtherNCPREFERRED CHIRO CARE
963043003OtherNCCIGNA
2117085094101OtherNCBEECH STREET
56-2215329OtherNCCNC
109362OtherNCWELLNESS PLAN
3467419OtherNCAETNA - HMO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070910000467 NC Practitioner - Chiropractic 9032202858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9123 Monroe Rd
Suite 100
Charlotte, NC 28270-2456
Phone (704) 569-3130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Permenter Chiropractic, Inc. Chiropractor CurrentSince Nov 1, 2000 Accepting new patients
Derrick W. Denman D.C. P.a. Chiropractor Past Accepting new patients
Lincoln Chiropractic, PC Chiropractor PastSince Jun 11, 2023 Accepting new patients

Locations

2301 Village Lake Dr
Charlotte, NC 28212
Phone (704) 569-3130

9123 Monroe Rd
Ste 100
Charlotte, NC 28270
Phone (704) 569-3130

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1122854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642636800000",
    "number": "1164422192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9123 MONROE RD STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282702456",
            "telephone_number": "704-569-3130",
            "fax_number": "704-569-9797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9123 MONROE RD STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282702456",
            "telephone_number": "704-569-3130",
            "fax_number": "704-569-9797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERMENTER",
        "first_name": "THOMAS",
        "middle_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-01",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA - PPO",
            "identifier": "7572054",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "790838F",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0838F",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN",
            "identifier": "606834-980061",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CHIRO CARE",
            "identifier": "NC3802",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "963043003",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEECH STREET",
            "identifier": "2117085094101",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CNC",
            "identifier": "56-2215329",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLNESS PLAN",
            "identifier": "109362",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA - HMO",
            "identifier": "3467419",
            "state": "NC"
        }
    ],
    "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 Jan 20, 2022; 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.