Individual provider Active NPI

Eric P Anderson, DC

  • Chiropractor
  • Charlotte, NC
National Provider Identifier
1194711663
Registry record updated Nov 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2628 Issued in NC
Practice address
8310 University Exec Park Dr
Suite 525
Charlotte, NC 28262-3383
Phone
(704) 549-1181
Fax
(704) 549-1145
NPI assigned
Sep 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2310 SC
Chiropractor 111N00000X 2628 NC Primary

Addresses

Primary practice location

8310 University Exec Park Dr
Suite 525
Charlotte, NC 28262-3383

Mailing address

8210 University Exec Park Dr
Ste 110
Charlotte, NC 28262-1329
Phone (704) 549-1181

Other identifiers 1

IdentifierTypeStateIssuer
890835MMedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070411000562 NC Practitioner - Chiropractic 2769587294 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8210 University Exec Park Dr
Suite 110
Charlotte, NC 28262-1329
Phone (704) 549-1181

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2310SCMDOccupational Therapist
2628NCMDSurgical Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Anderson Family Chiropractic, PLLC Chiropractor CurrentSince Jan 1, 2007 Accepting new patients

Locations

8210 University Exec Park Dr
Ste 110
Charlotte, NC 28262
Phone (704) 549-1181

8310 University Exec Park Dr
Ste 525
Charlotte, NC 28262
Phone (704) 549-1181

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": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574812800000",
    "number": "1194711663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8210 UNIVERSITY EXEC PARK DR",
            "address_2": "STE 110",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282621329",
            "telephone_number": "704-549-1181",
            "fax_number": "704-549-1145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8310 UNIVERSITY EXEC PARK DR",
            "address_2": "SUITE 525",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282623383",
            "telephone_number": "704-549-1181",
            "fax_number": "704-549-1145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ERIC",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2019-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "2310",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890835M",
            "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 Nov 27, 2019; 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.