Individual provider Active NPI

Dwayne E Thomas II, D.C.

  • Chiropractor
  • Charlotte, NC
National Provider Identifier
1255316709
Registry record updated Jun 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1534 Issued in NC
Practice address
5527 Monroe Rd
Charlotte, NC 28212
Phone
(704) 568-2447
Fax
(704) 568-2591
NPI assigned
Dec 7, 2005
Last updated
Jun 15, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1534 NC Primary

Addresses

Primary practice location

5527 Monroe Rd
Charlotte, NC 28212

Mailing address

5527 Monroe Rd
Charlotte, NC 28212-5503
Phone (704) 568-2447

Other identifiers 2

IdentifierTypeStateIssuer
08844OtherNCBLUE CROSS/BLUE SHIELD
7908844MedicaidNC

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1534NCMDHearing Instrument Specialist

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": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529020800000",
    "number": "1255316709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5527 MONROE RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282125503",
            "telephone_number": "704-568-2447",
            "fax_number": "704-568-2591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5527 MONROE RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28212",
            "telephone_number": "704-568-2447",
            "fax_number": "704-568-2591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "DWAYNE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2018-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "1534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "08844",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7908844",
            "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 Jun 15, 2018; 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.