NPIMap

Organization Active NPI

Cafe of Life, LLC

  • Chiropractor
  • Charlotte, NC
National Provider Identifier
1396807004
Registry record updated Sep 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2997 Issued in NC
Legal business name
CAFE OF LIFE, LLC
Practice address
2727 South Blvd
Charlotte, NC 28209-1109
Phone
(704) 521-1389
Fax
(704) 527-3687
NPI assigned
Dec 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2007

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

Authorized official

Name
Dr. Marco Peters, D.C.NPI 1134149073
Title
Manager
Phone
(704) 521-1389

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2997 NC Primary

Addresses

Primary practice location

2727 South Blvd
Charlotte, NC 28209-1109

Mailing address

2727 South Blvd
Charlotte, NC 28209-1109

Other names 1

  • Cafe of Life Chiropractic Other name

National Provider Directory

National Provider Directory

Locations

2727 South Blvd
Charlotte, NC 28209
Phone (704) 521-1389

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189987200000",
    "number": "1396807004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2727 SOUTH BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282091109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 SOUTH BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282091109",
            "telephone_number": "704-521-1389",
            "fax_number": "704-527-3687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAFE OF LIFE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-16",
        "last_updated": "2007-09-17",
        "status": "A",
        "authorized_official_last_name": "PETERS",
        "authorized_official_first_name": "MARCO",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "704-521-1389",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cafe of Life Chiropractic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Sep 17, 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.