Organization Active NPI

South Charlotte Spine and Wellness Center, PC

  • Chiropractor
  • Mars Hill, NC
National Provider Identifier
1285850248
Registry record updated Mar 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3235 Issued in NC
Legal business name
SOUTH CHARLOTTE SPINE AND WELLNESS CENTER, PC
Practice address
342 Carl Eller Rd
Mars Hill, NC 28754-6000
Phone
(047) 560-2369
NPI assigned
Apr 18, 2007
Last updated
Mar 11, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2019

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

Authorized official

Name
Dr. Jacqueline Jessica Leonard, DCNPI 1205846029
Title
President
Phone
(047) 560-2369

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
Chiropractor 111N00000X 3235 NC Primary

Addresses

Primary practice location

342 Carl Eller Rd
Mars Hill, NC 28754-6000

Mailing address

342 Carl Eller Rd
Mars Hill, NC 28754-6000
Phone (047) 560-2369

Other practice location 1

17228 Lancaster Hwy
Suite 208
Charlotte, NC 28277-2078
Phone (704) 271-3160

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071030000067 NC Part B Supplier - Clinic/Group Practice 9739276346 Receives reassigned benefits from 4 practitioners
Practice locations: Mars Hill, NC

National Provider Directory

National Provider Directory

Locations

342 Carl Eller Rd
Mars Hill, NC 28754
Phone (828) 689-3777

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552262400000",
    "number": "1285850248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 CARL ELLER RD",
            "city": "MARS HILL",
            "state": "NC",
            "postal_code": "287546000",
            "telephone_number": "047-560-2369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 CARL ELLER RD",
            "city": "MARS HILL",
            "state": "NC",
            "postal_code": "287546000",
            "telephone_number": "047-560-2369"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17228 Lancaster Hwy",
            "address_2": "Suite 208",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282772078",
            "country_code": "US",
            "telephone_number": "704-271-3160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTH CHARLOTTE SPINE AND WELLNESS CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2019-03-11",
        "status": "A",
        "authorized_official_last_name": "LEONARD",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "JESSICA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "047-560-2369",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "3235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mars Hill, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; 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.