NPIMap

Organization Active NPI

South Eastern Chiropractic and Wellness

  • Chiropractor
  • Fayetteville, NC
National Provider Identifier
1316343544
Registry record updated Jan 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4497 Issued in NC
Legal business name
SOUTH EASTERN CHIROPRACTIC AND WELLNESS
Practice address
5114 Yadkin Rd
Suite 128
Fayetteville, NC 28303-6012
Phone
(910) 273-1368
NPI assigned
Nov 17, 2014
Last updated
Jan 7, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2015

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

Authorized official

Name
Dr. Tonya K Carlysle, DCNPI 1780080093
Title
Doctor
Phone
(910) 273-1368

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4497 NC Primary

Addresses

Primary practice location

5114 Yadkin Rd
Suite 128
Fayetteville, NC 28303-6012

Mailing address

PO Box 683
Fayetteville, NC 28302

National Provider Directory

National Provider Directory

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": "1416182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420588800000",
    "number": "1316343544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 683",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "28302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5114 YADKIN RD",
            "address_2": "SUITE 128",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283036012",
            "telephone_number": "910-273-1368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH EASTERN CHIROPRACTIC AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-17",
        "last_updated": "2015-01-07",
        "status": "A",
        "authorized_official_last_name": "CARLYSLE",
        "authorized_official_first_name": "TONYA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "910-273-1368",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "4497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.