Active NPI
Dennis Clay Caudill, D.C.
- Chiropractor
- Kannapolis, NC
National Provider Identifier
1346227279
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1087
- Practice address
- 2406 S Cannon Blvd
Kannapolis, NC 28083-6910 - Phone
- (704) 932-0801
- Fax
- (704) 934-0070
- NPI assigned
- Dec 30, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1087 | NC | Primary |
Addresses
Primary practice location
2406 S Cannon Blvd
Kannapolis, NC 28083-6910
Mailing address
2406 S Cannon Blvd
Kannapolis, NC 28083-6910
Phone (704) 932-0801
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8908296 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100218000859 | NC | Practitioner - Chiropractic | 2466596184 | Practice locations: Kannapolis, NC |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1087 | NC | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188518400000",
"number": "1346227279",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2406 S CANNON BLVD",
"city": "KANNAPOLIS",
"state": "NC",
"postal_code": "280836910",
"telephone_number": "704-932-0801",
"fax_number": "704-934-0070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2406 S CANNON BLVD",
"city": "KANNAPOLIS",
"state": "NC",
"postal_code": "280836910",
"telephone_number": "704-932-0801",
"fax_number": "704-934-0070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAUDILL",
"first_name": "DENNIS",
"middle_name": "CLAY",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-12-30",
"last_updated": "2007-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NC",
"license": "1087",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8908296",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kannapolis, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.