NPIMap

Organization Active NPI

Southpark Chiropractic Center Inc

  • Chiropractor
  • Charlotte, NC
National Provider Identifier
1386714681
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1812 Issued in NC
Legal business name
SOUTHPARK CHIROPRACTIC CENTER INC
Practice address
6626 Fairview Rd
Charlotte, NC 28210
Phone
(704) 362-5400
NPI assigned
Nov 8, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Elizabeth Hill AverickNPI 1083718233
Title
Owner
Phone
(704) 362-5400

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2553 SC
Chiropractor 111N00000X CH5078 FL
Chiropractor 111N00000X 1812 NC Primary

Addresses

Primary practice location

6626 Fairview Rd
Charlotte, NC 28210

Mailing address

6626 Fairview Rd
Charlotte, NC 28210
Phone (704) 362-5400

Other identifiers 1

IdentifierTypeStateIssuer
0853BOtherNCBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

6626 Fairview Rd
Charlotte, NC 28210
Phone (704) 362-5400

Practitioners & affiliated clinicians

Practitioners 3

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": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386714681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 FAIRVIEW RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28210",
            "telephone_number": "704-362-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6626 FAIRVIEW RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28210",
            "telephone_number": "704-362-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHPARK CHIROPRACTIC CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AVERICK",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "HILL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-362-5400",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "2553",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH5078",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "1812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0853B",
            "state": "NC"
        }
    ],
    "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 Aug 22, 2020; 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.