Organization Active NPI

Demaine Chiropractic &Wellnes Center PA

  • Chiropractor
  • Charlotte, NC
National Provider Identifier
1255367397
Registry record updated Feb 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2183 Issued in NC
Legal business name
DEMAINE CHIROPRACTIC &WELLNES CENTER PA
Practice address
504 Eastway Dr
Charlotte, NC 28205-1421
Phone
(704) 372-6960
NPI assigned
Jun 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2012

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

Authorized official

Name
Stephen David Demaine, DCNPI 1154398832
Title
Owner
Phone
(704) 372-6960

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2183 NC Primary

Addresses

Primary practice location

504 Eastway Dr
Charlotte, NC 28205-1421

Mailing address

504 Eastway Dr
Charlotte, NC 28205-1421
Phone (704) 372-6960

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060802000411 NC Part B Supplier - Clinic/Group Practice 6103802319 Receives reassigned benefits from 3 practitioners
Practice locations: Charlotte, NC

National Provider Directory

National Provider Directory

Locations

504 Eastway Dr
Charlotte, NC 28205
Phone (704) 372-6960

6253 South Blvd
Charlotte, NC 28217
Phone (704) 554-9711

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328572800000",
    "number": "1255367397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 EASTWAY DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282051421",
            "telephone_number": "704-372-6960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 EASTWAY DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282051421",
            "telephone_number": "704-372-6960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEMAINE CHIROPRACTIC &WELLNES CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2012-02-07",
        "status": "A",
        "authorized_official_last_name": "DEMAINE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-372-6960",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2183",
            "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 Feb 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.