Individual provider Active NPI

Shavahn Latise Witherspoon, D.C.

  • Chiropractor
  • Morrisville, NC
National Provider Identifier
1407169600
Registry record updated Nov 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC010282 Issued in PA
Practice address
133 Keybridge Dr Ste B
Morrisville, NC 27560-5915
Phone
(919) 378-9927
Fax
(919) 650-1861
NPI assigned
Jul 16, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC010282 PA Primary

Addresses

Primary practice location

133 Keybridge Dr Ste B
Morrisville, NC 27560-5915

Mailing address

133 Keybridge Dr Ste B
Morrisville, NC 27560-5915
Phone (919) 378-9927

Other practice location 1

4029 Market St # 37
Philadelphia, PA 19104-3265
Phone (215) 387-8800

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC010282PAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Triangle Community Chiropractic Center PastSince Nov 24, 2019 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": "1279238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1407169600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 KEYBRIDGE DR STE B",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275605915",
            "telephone_number": "919-378-9927",
            "fax_number": "919-650-1861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 KEYBRIDGE DR STE B",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275605915",
            "telephone_number": "919-378-9927",
            "fax_number": "919-650-1861"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4029 Market St # 37",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191043265",
            "country_code": "US",
            "telephone_number": "215-387-8800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WITHERSPOON",
        "first_name": "SHAVAHN",
        "middle_name": "LATISE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-16",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC010282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morrisville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; 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.