Organization Active NPI

Summit Health Solutions, PLLC

Doing business as Indian Trail Chiropractic and Rehabilitation

  • Chiropractor
  • Indian Trail, NC
National Provider Identifier
1437624541
Registry record updated Oct 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
SUMMIT HEALTH SOLUTIONS, PLLC
Doing business as
Indian Trail Chiropractic and Rehabilitation
Practice address
100 Park Rd E
Indian Trail, NC 28079-7622
Phone
(704) 821-3222
Fax
(704) 821-3290
NPI assigned
Oct 5, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2018

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

Authorized official

Name
Dr. Cameron Gentile, DCNPI 1225480221
Title
President
Phone
(704) 779-8796

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 Primary

Addresses

Primary practice location

100 Park Rd E
Indian Trail, NC 28079-7622

Mailing address

15077 Santa Lucia Dr
Charlotte, NC 28277-3629
Phone (704) 779-8796

Other names 1

  • Indian Trail Chiropractic and Rehabilitation Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190110001128 NC Part B Supplier - Clinic/Group Practice 0749526838 Receives reassigned benefits from 1 practitioner
Practice locations: Indian Trail, NC

National Provider Directory

National Provider Directory

Locations

100 Park Rd E
Indian Trail, NC 28079
Phone (704) 821-3222

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": "1538697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538697600000",
    "number": "1437624541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15077 SANTA LUCIA DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282773629",
            "telephone_number": "704-779-8796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PARK RD E",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "280797622",
            "telephone_number": "704-821-3222",
            "fax_number": "704-821-3290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT HEALTH SOLUTIONS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-05",
        "last_updated": "2018-10-05",
        "status": "A",
        "authorized_official_last_name": "GENTILE",
        "authorized_official_first_name": "CAMERON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-779-8796",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Indian Trail Chiropractic and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Indian Trail, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.