Individual provider Active NPI

Natalie George Randazzo, DC

  • Chiropractor
  • Charlotte, NC
National Provider Identifier
1275634545
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3066 Issued in NC
Practice address
8179 Ardrey Kell Rd
Ste 102
Charlotte, NC 28277
Phone
(704) 841-1122
Fax
(704) 841-1133
NPI assigned
Sep 26, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3066 NC Primary

Addresses

Primary practice location

8179 Ardrey Kell Rd
Ste 102
Charlotte, NC 28277

Mailing address

PO Box 78530
Charlotte, NC 28271
Phone (704) 841-1122

Other identifiers 1

IdentifierTypeStateIssuer
80985G7MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100820000895 NC Practitioner - Chiropractic 0042103848 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Charlotte Chiropractic PLLCGroup PAC ID 9436344991, 2 clinicians

Practice addresses (Care Compare)

8179 Ardrey Kell Rd
Suite 102
Charlotte, NC 28277-5717

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3066NCMDPsychologist
009469NYMDCritical Care Registered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
South Charlotte Chiropractic PLLC Chiropractor CurrentSince Apr 11, 2010 Accepting new patients
Monroe Chiropractic Clinic Past Accepting new patients
Weddington Chiropractic Wellness Center Past Accepting new patients
Tebby Clinic of Chiropractic PA Chiropractor PastSince Oct 31, 2003 Accepting new patients
Keith Clinic of Chiropractic, P.a. Chiropractor Past Accepting new patients
Daljit Buttar MD PC PastSince Apr 11, 2010 Accepting new patients
The Grenda Group LLC PastSince Aug 5, 2013 Accepting new patients

Locations

8179 Ardrey Kell Rd
Ste 102
Charlotte, NC 28277
Phone (704) 841-1122

Organizations & group practices 7

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": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275634545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 78530",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28271",
            "telephone_number": "704-841-1122",
            "fax_number": "704-841-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8179 ARDREY KELL RD",
            "address_2": "STE 102",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28277",
            "telephone_number": "704-841-1122",
            "fax_number": "704-841-1133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDAZZO",
        "first_name": "NATALIE",
        "middle_name": "GEORGE",
        "name_prefix": "Mrs.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "3066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "80985G7",
            "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 Jul 8, 2007; 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.