NPIMap

Organization Active NPI

Piedmont Chiropractic Center, P.a.

  • Orthopedic Chiropractor
  • Kernersville, NC
National Provider Identifier
1205931433
Registry record updated Aug 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic ChiropractorTaxonomy code 111NX0800X
License
2776 Issued in NC
Legal business name
PIEDMONT CHIROPRACTIC CENTER, P.A.
Practice address
851 Old Winston Road
Suite 105
Kernersville, NC 27284-8781
Phone
(336) 993-9690
Fax
(336) 993-9692
NPI assigned
Sep 13, 2006
Last updated
Aug 6, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2007

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

Authorized official

Name
Dr. David Dillon Parks, D.C.NPI 1770547937
Title
Owner
Phone
(336) 993-9690

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Chiropractor 111NX0800X 2776 NC Primary

Addresses

Primary practice location

851 Old Winston Road
Suite 105
Kernersville, NC 27284-8781

Mailing address

851 Old Winston Road
Suite 105
Kernersville, NC 27284-8781
Phone (336) 993-9690

Other identifiers 2

IdentifierTypeStateIssuer
0847MOtherNCBLUE-CROSS/ BLUE SHIELD
890847MMedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110920000708 NC Part B Supplier - Clinic/Group Practice 6608047824 Receives reassigned benefits from 1 practitioner
Practice locations: Kernersville, NC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186358400000",
    "number": "1205931433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 OLD WINSTON ROAD",
            "address_2": "SUITE 105",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272848781",
            "telephone_number": "336-993-9690",
            "fax_number": "336-993-9692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 OLD WINSTON ROAD",
            "address_2": "SUITE 105",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272848781",
            "telephone_number": "336-993-9690",
            "fax_number": "336-993-9692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIEDMONT CHIROPRACTIC CENTER, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2007-08-06",
        "status": "A",
        "authorized_official_last_name": "PARKS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "DILLON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-993-9690",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "NC",
            "license": "2776",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE-CROSS/ BLUE SHIELD",
            "identifier": "0847M",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890847M",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kernersville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.