Organization Active NPI

Carolina Chiropractic & Wellness Center

  • Chiropractor
  • Cornelius, NC
National Provider Identifier
1205934775
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CAROLINA CHIROPRACTIC & WELLNESS CENTER
Practice address
17115 Kenton Dr
Suite 206 a
Cornelius, NC 28031-5645
Phone
(704) 892-1010
Fax
(704) 892-1074
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Michael Todd Shipley, DC
Title
Owner
Phone
(704) 892-1010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

17115 Kenton Dr
Suite 206 a
Cornelius, NC 28031-5645

Mailing address

17115 Kenton Dr
Suite 206 a
Cornelius, NC 28031-5645
Phone (704) 892-1010

Other identifiers 1

IdentifierTypeStateIssuer
017V7OtherNCBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

17115 Kenton Dr
Ste 206A
Cornelius, NC 28031
Phone (704) 892-1010

16511 Northcross Dr
Ste E
Huntersville, NC 28078
Phone (704) 892-1010

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205934775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17115 KENTON DR",
            "address_2": "SUITE 206 A",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280315645",
            "telephone_number": "704-892-1010",
            "fax_number": "704-892-1074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17115 KENTON DR",
            "address_2": "SUITE 206 A",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280315645",
            "telephone_number": "704-892-1010",
            "fax_number": "704-892-1074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA CHIROPRACTIC & WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHIPLEY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "TODD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-892-1010",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "017V7",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cornelius, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.