NPIMap

Organization Active NPI

Shallotte Chiropractic PLLC

  • Chiropractor
  • Shallotte, NC
National Provider Identifier
1336386903
Registry record updated Aug 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3693 Issued in NC
Legal business name
SHALLOTTE CHIROPRACTIC PLLC
Practice address
4501 Main St Ste 2
Shallotte, NC 28470-4585
Phone
(910) 754-8090
Fax
(910) 754-8480
NPI assigned
Jan 19, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2009

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

Authorized official

Name
Dr. Carol A Mynatt, D.C.NPI 1184775900
Title
Owner
Phone
(910) 754-8090

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 3839 NC
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 3693 NC Primary

Addresses

Primary practice location

4501 Main St Ste 2
Shallotte, NC 28470-4585

Mailing address

4501 Main St Ste 2
Shallotte, NC 28470-4585
Phone (910) 754-8090

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1232323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251417600000",
    "number": "1336386903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 MAIN ST STE 2",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284704585",
            "telephone_number": "910-754-8090",
            "fax_number": "910-754-8480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 MAIN ST STE 2",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284704585",
            "telephone_number": "910-754-8090",
            "fax_number": "910-754-8480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHALLOTTE CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-19",
        "last_updated": "2009-08-28",
        "status": "A",
        "authorized_official_last_name": "MYNATT",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-754-8090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "3839",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "3693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shallotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2009; 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.