Individual provider Active NPI

Shelby Forrester, DC

  • Chiropractor
  • Indian Trail, NC
National Provider Identifier
1316510274
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5371 Issued in NC
Practice address
6580 Old Monroe Rd Ste a
Indian Trail, NC 28079-5362
Phone
(704) 225-8686
NPI assigned
Jul 20, 2021
Last updated
Jul 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5371 NC Primary

Addresses

Primary practice location

6580 Old Monroe Rd Ste a
Indian Trail, NC 28079-5362

Mailing address

10629 Monrovia Dr Apt 210
Matthews, NC 28105-5597
Phone (734) 770-0220

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210920000737 NC Practitioner - Chiropractic 8022415090 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Group practices
Integrative Chiropractic and Natural MedicineGroup PAC ID 6204082126, 4 clinicians

Practice addresses (Care Compare)

6580 Old Monroe Rd
Suite a
Indian Trail, NC 28079-5362
Phone (704) 225-8686

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5371NCMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Chiropractic and Natural Medicine Chiropractor CurrentSince Jul 16, 2021 Accepting new patients

Locations

6580 Old Monroe Rd
Ste A
Indian Trail, NC 28079
Phone (704) 225-8686

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1626739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1316510274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10629 MONROVIA DR APT 210",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281055597",
            "telephone_number": "734-770-0220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6580 OLD MONROE RD STE A",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "280795362",
            "telephone_number": "704-225-8686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORRESTER",
        "first_name": "SHELBY",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-20",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "5371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indian Trail, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.