Individual provider Active NPI

Lemuel P Byrd Jr., DC

  • Chiropractor
  • Charlotte, NC
National Provider Identifier
1205835543
Registry record updated Sep 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1150 Issued in NC
Practice address
4016 Triangle Dr
Charlotte, NC 28208-2828
Phone
(704) 392-1338
Fax
(704) 392-8156
NPI assigned
Jul 19, 2005
Last updated
Sep 16, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1150 NC Primary

Addresses

Primary practice location

4016 Triangle Dr
Charlotte, NC 28208-2828

Mailing address

4016 Triangle Dr
Charlotte, NC 28208-2828
Phone (704) 392-1338

Other identifiers 1

IdentifierTypeStateIssuer
890837BMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1150NCMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Keith Clinic of Chiropractic, P.a. Chiropractor Current Accepting new patients

Locations

4016 Triangle Dr
Charlotte, NC 28208
Phone (704) 392-1338

4024 Triangle Dr
Charlotte, NC 28208
Phone (704) 319-9200

8415 South Blvd
Charlotte, NC 28273
Phone (704) 541-7111

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221523200000",
    "number": "1205835543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4016 TRIANGLE DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282082828",
            "telephone_number": "704-392-1338",
            "fax_number": "704-392-8156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4016 TRIANGLE DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282082828",
            "telephone_number": "704-392-1338",
            "fax_number": "704-392-8156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYRD",
        "first_name": "LEMUEL",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2008-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "1150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890837B",
            "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 Sep 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.