Organization Active NPI

Matthews Family Chiropractic PC

  • Chiropractor
  • Matthews, NC
National Provider Identifier
1164622502
Registry record updated Mar 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
MATTHEWS FAMILY CHIROPRACTIC PC
Practice address
9808 Northeast Pkwy
Matthews, NC 28105-3742
Phone
(704) 845-0699
Fax
(704) 841-1808
NPI assigned
Jul 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2009

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

Authorized official

Name
Dr. John J Hanna, D.C.NPI 1477550457
Title
Director
Phone
(704) 845-0699

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

9808 Northeast Pkwy
Matthews, NC 28105-3742

Mailing address

9808 Northeast Pkwy
Matthews, NC 28105-3742
Phone (704) 845-0699

Other identifiers 2

IdentifierTypeStateIssuer
890946EMedicaidNC
0846EOtherNCBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090507000345 NC Part B Supplier - Clinic/Group Practice 3173671864 Receives reassigned benefits from 1 practitioner
Practice locations: Matthews, NC

National Provider Directory

National Provider Directory

Locations

9808 Northeast Pkwy
Matthews, NC 28105
Phone (704) 845-0699

Practitioners & affiliated clinicians

Practitioners 4

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": "1185235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237248000000",
    "number": "1164622502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9808 NORTHEAST PKWY",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281053742",
            "telephone_number": "704-845-0699",
            "fax_number": "704-841-1808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9808 NORTHEAST PKWY",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281053742",
            "telephone_number": "704-845-0699",
            "fax_number": "704-841-1808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEWS FAMILY CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-24",
        "last_updated": "2009-03-17",
        "status": "A",
        "authorized_official_last_name": "HANNA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "704-845-0699",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890946E",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0846E",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Matthews, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.