Individual provider Active NPI

Kristen Shook, DC

  • Chiropractor
  • Charlotte, NC
National Provider Identifier
1255163887
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5808 Issued in NC
Practice address
447 E 12TH St Apt 136
Charlotte, NC 28206-0505
Phone
(828) 461-1523
NPI assigned
Aug 14, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5808 NC Primary

Addresses

Primary practice location

447 E 12TH St Apt 136
Charlotte, NC 28206-0505

Mailing address

447 E 12TH St Apt 136
Charlotte, NC 28206-0505
Phone (828) 461-1523

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241014001129 NC Practitioner - Chiropractic 4981136108 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

131 Crosslake Park Dr
Suite 101
Mooresville, NC 28117-8234
Phone (704) 360-9795

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5808NCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ability Chiropractic Mooresville PLLC Chiropractor CurrentSince Sep 12, 2024 Accepting new patients

Locations

131 Crosslake Park Dr
Ste 101
Mooresville, NC 28117
Phone (704) 360-9795

170 W Olentangy St
Ste P
Powell, OH 43065
Phone (614) 907-9355

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1723593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1255163887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "447 E 12TH ST APT 136",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282060505",
            "telephone_number": "828-461-1523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "447 E 12TH ST APT 136",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282060505",
            "telephone_number": "828-461-1523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOOK",
        "first_name": "KRISTEN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-14",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "5808",
            "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 Aug 14, 2024; 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.