Individual provider Active NPI

Nicholas Gonzales, D.C.

  • Chiropractor
  • Lexington, NC
National Provider Identifier
1205309804
Registry record updated Jan 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4975 Issued in NC
Practice address
215 W US Highway 64 Ste 1
Lexington, NC 27295-2508
Phone
(336) 243-5433
NPI assigned
Jan 7, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4975 NC Primary

Addresses

Primary practice location

215 W US Highway 64 Ste 1
Lexington, NC 27295-2508

Mailing address

215 W US Highway 64 Ste 1
Lexington, NC 27295-2508
Phone (336) 243-5433

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190226000678 NC Practitioner - Chiropractic 9335488915 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2018
Medicare assignment
May accept Medicare assignment
Group practices
Active Chiropractic Rehab and AcupunctureGroup PAC ID 9537532536, 2 clinicians

Practice addresses (Care Compare)

519 Brookdale Dr
Statesville, NC 28677-4107
Phone (704) 380-2800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Active Chiropractic Rehab and Acupuncture Chiropractor CurrentSince Sep 15, 2024 Accepting new patients

Locations

519 Brookdale Dr
Statesville, NC 28677
Phone (704) 380-2800

Organizations & group practices 2

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": "1546819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546819200000",
    "number": "1205309804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 W US HIGHWAY 64 STE 1",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "272952508",
            "telephone_number": "336-243-5433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 W US HIGHWAY 64 STE 1",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "272952508",
            "telephone_number": "336-243-5433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "NICHOLAS",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-07",
        "last_updated": "2019-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "4975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.