W Raymond Chavez, DC
Individual provider Active NPI Chiropractor · Canton, NC
NPI 1275708703 · NPPES record last updated Aug 11, 2022
Key facts
- NPI
- 1275708703
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 3747 (NC)
- Practice address
- 462 Main St
Ste C
Canton, NC 28716-4487 - Phone
- (828) 681-0811
- NPI assigned
- Apr 25, 2008
- Sex
- Male
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Los Angeles College of Chiropractic, 1997
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
462 Main St
Suite C
Canton, NC 28716-4487
Phone (828) 648-1122
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081222000665 | NC | Practitioner - Chiropractic | 6305864364 | Practice locations: Canton, NC |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3747 | NC | MD | General Practice Dentistry |
| 5853 | AZ | MD | Hematology & Oncology Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3747 | NC | Yes |
Addresses
Primary practice location
462 Main St
Ste C
Canton, NC 28716-4487
Mailing address
462 Main St
Ste C
Canton, NC 28716-4487
Phone (828) 648-1122
Other names
- Dr. Wallace Raymond Chavez
Other providers in Canton, NC
- Tammie Cagle
- Canton Physical Therapy LLC
- Joshua Daniel Carpenter
- Alexandra Chamberlain
- Chappell Valley Cottage
- Natosha E Cook
- Austin Christopher Creith
- Eddie Ray Davenport III
- Jennifer Lynn Davis
- Ariana Debussey
All providers in Canton, NC · Chiropractor in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.