Gary Paul Dackor, DC – Chiropractor in Aberdeen, NC

Key facts

NPI: 1316900350
Entity type: Individual (NPI type 1)
Primary specialty: Chiropractor 111N00000X
License: 695 (NC)
Practice address: 1701 N Sandhills Blvd
Suite D
Aberdeen, NC 28315-2337
Phone: (910) 944-7889
NPI assigned: Apr 10, 2006
Sex: Male
Sole proprietor: Yes

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 and National Provider Directory roles.

First Chiropractic of the Sandhills Chiropractor · Aberdeen, NC · NPI 1497153175

NPD (past) CHIROPRACTOR

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
695	NC	MD	Acupuncturist

Practice roles

Organization	Specialty	Status	New patients
First Chiropractic of the Sandhills	Chiropractor	Past since Dec 8, 2014	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Chiropractor	111N00000X	695	NC	Yes

Addresses

Primary practice location

1701 N Sandhills Blvd
Suite D
Aberdeen, NC 28315-2337

Mailing address

1701 N Sandhills Blvd
Suite D
Aberdeen, NC 28315-2337
Phone (910) 944-7889

Other identifiers

Identifier	Type	State	Issuer
8908332	Medicaid	NC

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 13, 2012.

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326412800000",
    "number": "1316900350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 N SANDHILLS BLVD",
            "address_2": "SUITE D",
            "city": "ABERDEEN",
            "state": "NC",
            "postal_code": "283152337",
            "telephone_number": "910-944-7889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N SANDHILLS BLVD",
            "address_2": "SUITE D",
            "city": "ABERDEEN",
            "state": "NC",
            "postal_code": "283152337",
            "telephone_number": "910-944-7889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DACKOR",
        "first_name": "GARY",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2012-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8908332",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen, NC

All providers in Aberdeen, NC · Chiropractor in North Carolina

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 13, 2012. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.