Individual provider Active NPI

Timothy Shawn Cheuvront, DC

  • Chiropractor
  • Matthews, NC
National Provider Identifier
1174629133
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2128 Issued in NC
Practice address
455 W John St
Matthews, NC 28105-5354
Phone
(704) 841-2200
Fax
(704) 841-2534
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2128 NC Primary

Addresses

Primary practice location

455 W John St
Matthews, NC 28105-5354

Mailing address

455 W John St
Matthews, NC 28105-5354
Phone (704) 841-2200

Other identifiers 3

IdentifierTypeStateIssuer
0872EOtherNCBLUE CROSS BLUE SHIELD
5315633OtherNCAETNA
890872EMedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071105000375 NC Practitioner - Chiropractic 3577650753 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

455 W John St
Matthews, NC 28105-5354
Phone (704) 841-2200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cheuvront Clinic of Chiropractic & Sports Medicine Inc Chiropractor CurrentSince Feb 9, 2009 Accepting new patients

Locations

9940 Monroe Rd
Ste 101
Matthews, NC 28105
Phone (704) 841-2200

455 W John St
Matthews, NC 28105
Phone (704) 841-2200

Organizations & group practices 1

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": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1174629133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 W JOHN ST",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281055354",
            "telephone_number": "704-841-2200",
            "fax_number": "704-841-2534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 W JOHN ST",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281055354",
            "telephone_number": "704-841-2200",
            "fax_number": "704-841-2534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEUVRONT",
        "first_name": "TIMOTHY",
        "middle_name": "SHAWN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0872E",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5315633",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890872E",
            "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 Oct 23, 2024; 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.