Individual provider Active NPI

Jonathan David Stevens, D.C.

  • Chiropractor
  • Charlotte, NC
National Provider Identifier
1245574607
Registry record updated Nov 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4261 Issued in NC
Practice address
4012 Park Rd
Suite 103
Charlotte, NC 28209-2377
Phone
(704) 780-1066
NPI assigned
Nov 23, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4261 NC Primary

Addresses

Primary practice location

4012 Park Rd
Suite 103
Charlotte, NC 28209-2377

Mailing address

4012 Park Rd
Suite 103
Charlotte, NC 28209-2377
Phone (704) 780-1066

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4261NCMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1353628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353628800000",
    "number": "1245574607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4012 PARK RD",
            "address_2": "SUITE 103",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282092377",
            "telephone_number": "704-780-1066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4012 PARK RD",
            "address_2": "SUITE 103",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282092377",
            "telephone_number": "704-780-1066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "JONATHAN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-23",
        "last_updated": "2012-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "4261",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Nov 23, 2012; 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.