Individual provider Active NPI

Robert Brett Stockdale, D.C.

  • Chiropractor
  • Cary, NC
National Provider Identifier
1396752135
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2509 Issued in NC
Practice address
311 Ashville Ave Ste K
Cary, NC 27511-6668
Phone
(919) 851-0309
Fax
(919) 851-7259
NPI assigned
Aug 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2509 NC Primary

Addresses

Primary practice location

311 Ashville Ave Ste K
Cary, NC 27511-6668

Mailing address

311 Ashville Ave Ste K
Cary, NC 27511-6668
Phone (919) 851-0309

Other identifiers 1

IdentifierTypeStateIssuer
890831QMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2509NCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Stockdale Chiropractic Center, P.L.L.C. Chiropractor Past Accepting new patients

Organizations & group practices 1

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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396752135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 ASHVILLE AVE STE K",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275116668",
            "telephone_number": "919-851-0309",
            "fax_number": "919-851-7259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 ASHVILLE AVE STE K",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275116668",
            "telephone_number": "919-851-0309",
            "fax_number": "919-851-7259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCKDALE",
        "first_name": "ROBERT",
        "middle_name": "BRETT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890831Q",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.