Simon Paul Calvillo, D.C
Individual provider Active NPI Chiropractor · Forest City, NC
NPI 1437265477 · NPPES record last updated Apr 28, 2017
Key facts
- NPI
- 1437265477
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 2198 (NC)
- Practice address
- 1322 W Main St
Forest City, NC 28043-2555 - Phone
- (828) 245-4002
- Fax
- (828) 245-4025
- NPI assigned
- Aug 22, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Other, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Integrity Health Options, PA
Practice addresses (Care Compare)
627 Withrow Rd
Forest City, NC 28043-9695
Phone (828) 245-4002
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120612000637 | NC | Practitioner - Chiropractic | 9638333180 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4234 | CO | MD | Chiropractor |
| 2198 | NC | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Integrity Health Options, PA | Chiropractor | Current |
Accepting new patients |
Locations
627 Withrow Rd
Forest City, NC 28043
Phone (828) 245-4002
1322 W Main St
Forest City, NC 28043
Phone (828) 245-1111
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2198 | NC | Yes |
| Chiropractor | 111N00000X | 4234 | CO |
Addresses
Primary practice location
1322 W Main St
Forest City, NC 28043-2555
Mailing address
1322 W Main St
Forest City, NC 28043-2555
Phone (828) 289-6828
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 890829F | Medicaid | NC | |
| 0829F | Other | NC | BLUE CROSS BLUE SHIELD |
| 262694 | Other | NC | MAMSI |
| 14163723 | Other | NC | WASAU |
Other providers in Forest City, NC
- Anne Lucy Brock
- Katherine Allene Brooks Smart
- Katy Lynn Buchanan
- Christian Donald Burley
- Chasitty Camp Calhoun
- Carolina Chiropractic Plus of Rutherford
- Carolina Chiropractic Plus of Rutherford County Inc.
- Carolinas Physicians Network Inc
- Carolinas Physicians Network Inc
- Carolinas Physicians Network Inc
All providers in Forest City, NC · Chiropractor in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 28, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.