Individual provider Active NPI

Emil Lara

  • Chiropractor
  • Charlotte, NC
National Provider Identifier
1336560580
Registry record updated Dec 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4418 Issued in NC
Practice address
402 E Sugar Creek Rd
Charlotte, NC 28213-6913
Phone
(704) 405-7000
Fax
(704) 405-7001
NPI assigned
Dec 13, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4418 NC Primary

Addresses

Primary practice location

402 E Sugar Creek Rd
Charlotte, NC 28213-6913

Mailing address

402 E Sugar Creek Rd
Charlotte, NC 28213-6913
Phone (704) 405-7000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140218001820 NC Practitioner - Chiropractic 0749419687 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National Medical University, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Estramonte Chiropractic West PAGroup PAC ID 1951587583, 2 clinicians

Practice addresses (Care Compare)

4016 Triangle Dr
Charlotte, NC 28208-2828
Phone (704) 392-1338

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4418NCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Estramonte Chiropractic & Wellness Center East, P.a. Chiropractor CurrentSince Aug 1, 2018 Accepting new patients
Estramonte Chiropractic West PA Chiropractor CurrentSince May 1, 2017 Accepting new patients
Estramonte Chiropractic & Wellness Center Chiropractor CurrentSince Jan 3, 2014 Accepting new patients

Locations

4016 Triangle Dr
Charlotte, NC 28208
Phone (704) 392-1338

402 E Sugar Creek Rd
Charlotte, NC 28213
Phone (704) 405-7000

5344 Central Ave
Charlotte, NC 28212
Phone (704) 568-4195

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1386892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386892800000",
    "number": "1336560580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 E SUGAR CREEK RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282136913",
            "telephone_number": "704-405-7000",
            "fax_number": "704-405-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 E SUGAR CREEK RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282136913",
            "telephone_number": "704-405-7000",
            "fax_number": "704-405-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARA",
        "first_name": "EMIL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-13",
        "last_updated": "2013-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "4418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2013; 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.