NPIMap

Organization Active NPI

Back to Health Southpoint

  • Chiropractor
  • Durham, NC
National Provider Identifier
1164801155
Registry record updated May 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2687 Issued in NC
Legal business name
BACK TO HEALTH SOUTHPOINT
Practice address
6224 Fayetteville Rd
106B
Durham, NC 27713-6288
Phone
(919) 544-8881
Fax
(919) 544-8889
NPI assigned
May 22, 2015
Last updated
May 22, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2015

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

Authorized official

Name
Dr. Kenenth Brown, DC
Title
Ceo
Phone
(919) 544-8881

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2687 NC Primary

Addresses

Primary practice location

6224 Fayetteville Rd
106B
Durham, NC 27713-6288

Mailing address

6224 Fayetteville Rd
106B
Durham, NC 27713-6288
Phone (919) 544-8881

Other identifiers 3

IdentifierTypeStateIssuer
085FROtherNCBCBS
621714OtherNCUNITED HEALTH CARE
1252060OtherNCCOVENTRY

Other names 1

  • Back To Health CMC Inc Former legal business name

National Provider Directory

National Provider Directory

Locations

6224 Fayetteville Rd
Ste 106B
Durham, NC 27713
Phone (919) 544-8881

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1432252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432252800000",
    "number": "1164801155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6224 FAYETTEVILLE RD",
            "address_2": "106B",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277136288",
            "telephone_number": "919-544-8881",
            "fax_number": "919-544-8889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6224 FAYETTEVILLE RD",
            "address_2": "106B",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277136288",
            "telephone_number": "919-544-8881",
            "fax_number": "919-544-8889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK TO HEALTH SOUTHPOINT",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-22",
        "last_updated": "2015-05-22",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "KENENTH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-544-8881",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "085FR",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "621714",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "1252060",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Back To Health CMC Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.