Individual provider Active NPI

Michael Barry Rosen, D.C.

  • Chiropractor
  • Wilmington, NC
National Provider Identifier
1194737635
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2531 Issued in NC
Practice address
6303 Oleander Dr
Suite #102a
Wilmington, NC 28403-3590
Phone
(910) 313-1322
Fax
(910) 313-1323
NPI assigned
Aug 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2531 NC Primary

Addresses

Primary practice location

6303 Oleander Dr
Suite #102a
Wilmington, NC 28403-3590

Mailing address

6303 Oleander Dr
Suite #102a
Wilmington, NC 28403-3590
Phone (910) 313-1322

Other identifiers 3

IdentifierTypeStateIssuer
32283OtherNCPARTNERS
7908232MedicaidNC
08232OtherNCBLUE CROSS/BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100819000271 NC Practitioner - Chiropractic 2163556622 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Back in Motion Chiropractic, Inc.Group PAC ID 8325006638, 2 clinicians

Practice addresses (Care Compare)

6303 Oleander Dr
Wilmington, NC 28403-3577
Phone (910) 313-1322

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2531NCMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Back in Motion Chiropractic, Inc. Chiropractor CurrentSince Oct 1, 1998 Accepting new patients

Locations

6303 Oleander Dr
Ste 102A
Wilmington, NC 28403
Phone (910) 313-1322

6303 Oleander Dr
Ste 104B
Wilmington, NC 28403
Phone (910) 313-1322

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": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194737635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6303 OLEANDER DR",
            "address_2": "SUITE #102A",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284033590",
            "telephone_number": "910-313-1322",
            "fax_number": "910-313-1323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6303 OLEANDER DR",
            "address_2": "SUITE #102A",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284033590",
            "telephone_number": "910-313-1322",
            "fax_number": "910-313-1323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEN",
        "first_name": "MICHAEL",
        "middle_name": "BARRY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS",
            "identifier": "32283",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7908232",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "08232",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.