Individual provider Active NPI

Jon Andrew Dominique, D.C.

  • Chiropractor
  • Morganton, NC
National Provider Identifier
1245395565
Registry record updated Jun 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3971 Issued in NC
Practice address
205 Carbon City Rd
Morganton, NC 28655-4238
Phone
(828) 433-1071
NPI assigned
Dec 27, 2006
Last updated
Jun 16, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3831 OH
Chiropractor 111N00000X 038011253 IL
Chiropractor 111N00000X 3971 NC Primary

Addresses

Primary practice location

205 Carbon City Rd
Morganton, NC 28655-4238

Mailing address

205 Carbon City Rd
Morganton, NC 28655-4238
Phone (419) 572-0025

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100830000533 NC Practitioner - Chiropractic 3577687474 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dominique Chiropractic IncGroup PAC ID 8426213059, 2 clinicians

Practice addresses (Care Compare)

401 S Green St
Morganton, NC 28655-3528

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038011253ILMDChiropractor
3831OHMDChiropractor
3971NCMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dominique Chiropractic, Inc. CurrentSince Apr 1, 2012 Accepting new patients
Alpine Chiropractic Center Chiropractor Past Accepting new patients

Locations

205 Carbon City Rd
Morganton, NC 28655
Phone (828) 433-1071

401 S Green St
Morganton, NC 28655
Phone (828) 433-1070

401 S Green St
#A
Morganton, NC 28655
Phone (828) 433-1071

Organizations & group practices 2

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": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276646400000",
    "number": "1245395565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 CARBON CITY RD",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286554238",
            "telephone_number": "419-572-0025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 CARBON CITY RD",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286554238",
            "telephone_number": "828-433-1071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINIQUE",
        "first_name": "JON",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2010-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "3831",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038011253",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "3971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morganton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2010; 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.