NPIMap

Organization Active NPI

Team Chiropractic & Sports Medicine, PA

  • Chiropractor
  • Raleigh, NC
National Provider Identifier
1316086366
Registry record updated Aug 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2172 Issued in NC
Legal business name
TEAM CHIROPRACTIC & SPORTS MEDICINE, PA
Practice address
309-199 W Millbrook Rd
Raleigh, NC 27609-4385
Phone
(919) 788-8881
Fax
(919) 788-8818
NPI assigned
Feb 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2007

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

Authorized official

Name
Dr. Lawrence D Dodd, D.C.NPI 1447244744
Title
Chiropractor
Phone
(919) 788-8881

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 2172 NC Primary

Addresses

Primary practice location

309-199 W Millbrook Rd
Raleigh, NC 27609-4385

Mailing address

309-199 W Millbrook Rd
Raleigh, NC 27609-4385
Phone (919) 788-8881

Other identifiers 5

IdentifierTypeStateIssuer
2346483OtherNCMEDICARE GROUP NUMBER
7908316MedicaidNC
0201UOtherNCBCBS GROUP NUMBER
08316OtherNCBCBS INDIVIDUAL DODD
790201UOtherNCMEDICAID GROUP NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050816000479 NC Part B Supplier - Clinic/Group Practice 4981634383 Receives reassigned benefits from 1 practitioner
Practice locations: Raleigh, NC

National Provider Directory

National Provider Directory

Locations

12740 Spruce Tree Way
Raleigh, NC 27614
Phone (919) 570-6160

309 W Millbrook Rd
Ste 199
Raleigh, NC 27609
Phone (919) 788-8881

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187740800000",
    "number": "1316086366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309-199 W MILLBROOK RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276094385",
            "telephone_number": "919-788-8881",
            "fax_number": "919-788-8818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309-199 W MILLBROOK RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276094385",
            "telephone_number": "919-788-8881",
            "fax_number": "919-788-8818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEAM CHIROPRACTIC & SPORTS MEDICINE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-08-22",
        "status": "A",
        "authorized_official_last_name": "DODD",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "919-788-8881",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "2346483",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7908316",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "0201U",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIVIDUAL DODD",
            "identifier": "08316",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP NUMBER",
            "identifier": "790201U",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2007; 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.