The Wellness Center of the Outer Banks Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1672 Issued in NC

Legal business name

THE WELLNESS CENTER OF THE OUTER BANKS INC

Practice address

3723 N. Croatan Hwy
Unit G
Kitty Hawk, NC 27949

Phone

(252) 261-5424

Fax

(252) 261-5324

NPI assigned

Feb 18, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Daniel Goldberg, D.C.

Title

President

Phone

(252) 261-5424

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1266451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266451200000",
    "number": "1326360371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 262",
            "address_2": "3723 N. CROATAN HWY",
            "city": "KITTY HAWK",
            "state": "NC",
            "postal_code": "279490262",
            "telephone_number": "252-261-5424",
            "fax_number": "252-261-5324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3723 N. CROATAN HWY",
            "address_2": "UNIT G",
            "city": "KITTY HAWK",
            "state": "NC",
            "postal_code": "27949",
            "telephone_number": "252-261-5424",
            "fax_number": "252-261-5324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WELLNESS CENTER OF THE OUTER BANKS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-18",
        "last_updated": "2010-02-18",
        "status": "A",
        "authorized_official_last_name": "GOLDBERG",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "252-261-5424",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "1672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890844A",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF NC",
            "identifier": "0844A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Stumph, PHARMD
• Kathryn Haley Sullivan, NC LMBT
• Sarah Summerton, FNP-BC
• Surf Pediatrics and Medicine PC
• Steve Taylor, LCMHCA, LCAS
• Jennifer Thiessen, FNP-C
• Alexander Thompson, DMD
• Katherine Sweeney Thompson
• Thrivewell Network LLC
• Stacey Michelle Tillett

• Chiropractor in Kitty Hawk, NC
• Providers in Kitty Hawk, NC by specialty
• Chiropractor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2010; 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.