NPIMap

Organization Active NPI

Walraven Chiropractic

  • Chiropractor
  • Charlotte, NC
National Provider Identifier
1225227796
Registry record updated May 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3275 Issued in NC
Legal business name
WALRAVEN CHIROPRACTIC
Practice address
3010 Monroe Rd
Suite 105
Charlotte, NC 28205-7532
Phone
(704) 334-3761
Fax
(704) 334-3763
NPI assigned
Oct 19, 2007
Last updated
May 21, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2008

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

Authorized official

Name
Dr. Darcey WalravenNPI 1184642092
Title
Dr
Phone
(704) 334-3761

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
Chiropractor 111N00000X 3275 NC Primary

Addresses

Primary practice location

3010 Monroe Rd
Suite 105
Charlotte, NC 28205-7532

Mailing address

10214 Chestnut Plaza Dr
Suite 190
Fort Wayne, IN 46814-8970
Phone (260) 625-6660

Other identifiers 2

IdentifierTypeStateIssuer
5908612MedicaidNC
89085UHMedicaidNC

National Provider Directory

National Provider Directory

Locations

10214 Chestnut Plaza Dr
Fort Wayne, IN 46814
Phone (260) 409-8188

Practitioners & affiliated clinicians

Practitioners 3

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": "1192752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211328000000",
    "number": "1225227796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10214 CHESTNUT PLAZA DR",
            "address_2": "SUITE 190",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468148970",
            "telephone_number": "260-625-6660",
            "fax_number": "260-625-6661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 MONROE RD",
            "address_2": "SUITE 105",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282057532",
            "telephone_number": "704-334-3761",
            "fax_number": "704-334-3763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALRAVEN CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-19",
        "last_updated": "2008-05-21",
        "status": "A",
        "authorized_official_last_name": "WALRAVEN",
        "authorized_official_first_name": "DARCEY",
        "authorized_official_title_or_position": "DR",
        "authorized_official_telephone_number": "704-334-3761",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "3275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5908612",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89085UH",
            "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 May 21, 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.