Individual provider Active NPI

William Tyler Earnst, D.C.

  • Chiropractor
  • Archdale, NC
National Provider Identifier
1225094089
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2600 Issued in NC
Practice address
231 Baker Rd
Archdale, NC 27263-2113
Phone
(336) 434-4600
Fax
(336) 434-4610
NPI assigned
Apr 21, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 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 2600 NC Primary

Addresses

Primary practice location

231 Baker Rd
Archdale, NC 27263-2113

Mailing address

231 Baker Rd
Archdale, NC 27263-2113
Phone (336) 434-4600

Other identifiers 2

IdentifierTypeStateIssuer
0835JOtherNCBCBSNC PROVIDER #
890835JMedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101012001142 NC Practitioner - Chiropractic 9638130917 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

231 Baker Rd
Archdale, NC 27263-2113
Phone (336) 434-4600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Earnst Clinic Inc Chiropractor CurrentSince Dec 17, 2002 Accepting new patients

Locations

231 Baker Rd
Archdale, NC 27263
Phone (336) 434-4600

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": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1225094089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 BAKER RD",
            "city": "ARCHDALE",
            "state": "NC",
            "postal_code": "272632113",
            "telephone_number": "336-434-4600",
            "fax_number": "336-434-4610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 BAKER RD",
            "city": "ARCHDALE",
            "state": "NC",
            "postal_code": "272632113",
            "telephone_number": "336-434-4600",
            "fax_number": "336-434-4610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARNST",
        "first_name": "WILLIAM",
        "middle_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-21",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC PROVIDER #",
            "identifier": "0835J",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890835J",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Archdale, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.