Individual provider Active NPI

Brian J Wirth, D.C.

  • Chiropractor
  • Greenville, NC
National Provider Identifier
1396077087
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4057 Issued in NC
Practice address
704 E. Arlington Blvd
Greenville, NC 27858
Phone
(252) 756-6111
Fax
(252) 756-6904
NPI assigned
Feb 4, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4057 NC Primary

Addresses

Primary practice location

704 E. Arlington Blvd
Greenville, NC 27858

Mailing address

704 E. Arlington Blvd
Greenville, NC 27858
Phone (252) 756-6111

Other identifiers 1

IdentifierTypeStateIssuer
4057OtherNCNC CHIROPRACTIC LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100518000670 NC Practitioner - Chiropractic 3678602380 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2009
Medicare assignment
May accept Medicare assignment
Group practices
Wirth Chiropractic PAGroup PAC ID 5496128233, 3 clinicians
Active Living Chiropractic IncGroup PAC ID 5698804300, 5 clinicians

Practice addresses (Care Compare)

2100 W Arlington Blvd
Greenville, NC 27834-6487
Phone (252) 999-9371

704 E Arlington Blvd
Greenville, NC 27858-5809
Phone (252) 756-6111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4057NCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Active Living Chiropractic Inc Chiropractor CurrentSince Apr 1, 2010 Accepting new patients
Wirth Chiropractic Kinston, P.a Chiropractor Current Accepting new patients
Wirth Chiropractic PA Chiropractor CurrentSince Jan 4, 2023 Accepting new patients

Locations

704 E Arlington Blvd
Greenville, NC 27858
Phone (252) 756-6111

2100 W Arlington Blvd
Greenville, NC 27834
Phone (252) 756-6111

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": "1265241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1396077087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 E. ARLINGTON BLVD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "27858",
            "telephone_number": "252-756-6111",
            "fax_number": "252-756-6904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 E. ARLINGTON BLVD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "27858",
            "telephone_number": "252-756-6111",
            "fax_number": "252-756-6904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIRTH",
        "first_name": "BRIAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-04",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "4057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC CHIROPRACTIC LICENSE",
            "identifier": "4057",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; 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.