Organization Active NPI

Edgerton Chiropractic Inc

  • Nutrition Chiropractor
  • Shelby, NC
National Provider Identifier
1265575765
Registry record updated May 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
1735 Issued in NC
Legal business name
EDGERTON CHIROPRACTIC INC
Practice address
421 South Main Street
Shelby, NC 28152
Phone
(704) 434-9130
Fax
(704) 434-9142
NPI assigned
Feb 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2018

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

Authorized official

Name
Dr. David Ezra Edgerton, D.C.
Title
Owner
Phone
(704) 434-9130

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111NN1001X 1735 NC Primary

Addresses

Primary practice location

421 South Main Street
Shelby, NC 28152

Mailing address

PO Box 1141
Boiling Springs, NC 28017
Phone (704) 434-9130

Other identifiers 2

IdentifierTypeStateIssuer
0858GOtherNCBLUE CROSS BLUE SHIELD
890858GMedicaidNC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527033600000",
    "number": "1265575765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1141",
            "city": "BOILING SPRINGS",
            "state": "NC",
            "postal_code": "28017",
            "telephone_number": "704-434-9130",
            "fax_number": "704-434-9923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 SOUTH MAIN STREET",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "28152",
            "telephone_number": "704-434-9130",
            "fax_number": "704-434-9142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGERTON CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2018-05-23",
        "status": "A",
        "authorized_official_last_name": "EDGERTON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "EZRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-434-9130",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor, Nutrition",
            "state": "NC",
            "license": "1735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0858G",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890858G",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.