Active NPI
Kenneth Jason Thomas, D.C.
- Chiropractor
- Charlotte, NC
National Provider Identifier
1316077340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3703
- Practice address
- 4016 Triangle Dr
Charlotte, NC 28208-2828 - Phone
- (704) 392-1338
- Fax
- (704) 392-8156
- NPI assigned
- Mar 7, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3703 | NC | Primary |
Addresses
Primary practice location
4016 Triangle Dr
Charlotte, NC 28208-2828
Mailing address
PO Box 667948
Charlotte, NC 28266-7948
Phone (704) 392-1338
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5907366 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3703 | NC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221523200000",
"number": "1316077340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 667948",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282667948",
"telephone_number": "704-392-1338",
"fax_number": "704-392-8156"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4016 TRIANGLE DR",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282082828",
"telephone_number": "704-392-1338",
"fax_number": "704-392-8156"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "KENNETH",
"middle_name": "JASON",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-07",
"last_updated": "2008-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NC",
"license": "3703",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5907366",
"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 Sep 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.