NPIMap

Organization Active NPI

Active Carolina Sports and Spine, Inc.

Doing business as Carolina Performance & Wellness

  • Chiropractor
  • Charlotte, NC
National Provider Identifier
1346590049
Registry record updated Nov 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3881 Issued in NC
Legal business name
ACTIVE CAROLINA SPORTS AND SPINE, INC.
Doing business as
Carolina Performance & Wellness
Practice address
10440 Park Rd
Suite 200
Charlotte, NC 28210-8504
Phone
(704) 541-7499
Fax
(704) 541-5565
NPI assigned
Sep 11, 2012
Last updated
Nov 21, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2012

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

Authorized official

Name
Dr. Ryan James Danner, D.C.NPI 1922259605
Title
Owner
Phone
(704) 541-7499

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3404 SC
Chiropractor 111N00000X 3881 NC Primary

Addresses

Primary practice location

10440 Park Rd
Suite 200
Charlotte, NC 28210-8504

Mailing address

10440 Park Rd
Suite 200
Charlotte, NC 28210-8504
Phone (704) 541-7499

Other names 1

  • Carolina Performance & Wellness Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1347321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353456000000",
    "number": "1346590049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10440 PARK RD",
            "address_2": "SUITE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108504",
            "telephone_number": "704-541-7499",
            "fax_number": "704-541-5565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10440 PARK RD",
            "address_2": "SUITE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108504",
            "telephone_number": "704-541-7499",
            "fax_number": "704-541-5565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE CAROLINA SPORTS AND SPINE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-11",
        "last_updated": "2012-11-21",
        "status": "A",
        "authorized_official_last_name": "DANNER",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-541-7499",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "3404",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "3881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carolina Performance & Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 21, 2012; 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.