Organization Active NPI

River City Chiropractic PC

  • Chiropractor
  • Elizabeth City, NC
National Provider Identifier
1316045065
Registry record updated Oct 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2338 Issued in NC
Legal business name
RIVER CITY CHIROPRACTIC PC
Practice address
224 N Poindexter St
Elizabeth City, NC 27909-4414
Phone
(252) 335-7709
Fax
(252) 331-7997
NPI assigned
Sep 20, 2006
Last updated
Oct 3, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2011

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

Authorized official

Name
Dr. Scott Michael Mawhiney, DCNPI 1124126859
Title
President
Phone
(252) 335-7709

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 2338 NC Primary

Addresses

Primary practice location

224 N Poindexter St
Elizabeth City, NC 27909-4414

Mailing address

224 N Poindexter St
Elizabeth City, NC 27909-4414
Phone (252) 335-7709

Other identifiers 2

IdentifierTypeStateIssuer
0833NOtherNCBC/BS NC
890833NMedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111130000000 NC Part B Supplier - Clinic/Group Practice 6507030665 Receives reassigned benefits from 1 practitioner
Practice locations: Elizabeth City, NC

National Provider Directory

National Provider Directory

Locations

224 N Poindexter St
Elizabeth Cty, NC 27909
Phone (252) 335-7709

Practitioners & affiliated clinicians

Practitioners 1

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": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317600000000",
    "number": "1316045065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 N POINDEXTER ST",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279094414",
            "telephone_number": "252-335-7709",
            "fax_number": "252-331-7997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 N POINDEXTER ST",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279094414",
            "telephone_number": "252-335-7709",
            "fax_number": "252-331-7997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER CITY CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2011-10-03",
        "status": "A",
        "authorized_official_last_name": "MAWHINEY",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "252-335-7709",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS NC",
            "identifier": "0833N",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890833N",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth City, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2011; 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.