Individual provider Active NPI

Salvatore Cosimo Daniele, B.S., D,C.

  • Chiropractor
  • Fayetteville, NC
National Provider Identifier
1184732430
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3330 Issued in NC
Practice address
1905 Skibo Rd Ste 103
Fayetteville, NC 28314-0261
Phone
(910) 480-1111
Fax
(910) 480-1113
NPI assigned
Aug 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 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 3330 NC Primary

Addresses

Primary practice location

1905 Skibo Rd Ste 103
Fayetteville, NC 28314-0261

Mailing address

439 Westwood Shopping Ctr
Suite 5
Fayetteville, NC 28314-1532
Phone (910) 480-1111

Other identifiers 6

IdentifierTypeStateIssuer
2457877OtherNCMEDICARE INDIVIDUAL PTAN
662673OtherNCAMERICAN CHIRO. NETWORK
085UXOtherNCBLUE CROSS/BLUE SHIELD
607554400OtherNCACS-DEPT. OF LABOR
2457877OtherNCMEDICARE GROUP/ORGANIZATION PTAN
89085UXMedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050513000685 NC Practitioner - Chiropractic 0547248809 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1905 Skibo Rd
Suite 103
Fayetteville, NC 28314-0261
Phone (910) 480-1111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
3330NCMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Aguayo Chiropractic PC Chiropractor PastSince Jan 1, 2004 Accepting new patients
Chiropractic Plus PA Chiropractor PastSince Mar 1, 2005 Accepting new patients

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": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1184732430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "439 WESTWOOD SHOPPING CTR",
            "address_2": "SUITE 5",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283141532",
            "telephone_number": "910-480-1111",
            "fax_number": "910-480-1113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 SKIBO RD STE 103",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283140261",
            "telephone_number": "910-480-1111",
            "fax_number": "910-480-1113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELE",
        "first_name": "SALVATORE",
        "middle_name": "COSIMO",
        "name_prefix": "Dr.",
        "credential": "B.S., D,C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "3330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL PTAN",
            "identifier": "2457877",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN CHIRO. NETWORK",
            "identifier": "662673",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "085UX",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACS-DEPT. OF LABOR",
            "identifier": "607554400",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP/ORGANIZATION PTAN",
            "identifier": "2457877",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89085UX",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.