Individual provider Active NPI

Sydney Stroud Lassiter, DC

  • Chiropractor
  • Archdale, NC
National Provider Identifier
1467030460
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5304 Issued in NC
Practice address
3204 Archdale Rd
Archdale, NC 27263-2710
Phone
(336) 434-2107
Fax
(336) 434-2109
NPI assigned
Mar 31, 2021
Last updated
Jan 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5304 NC Primary

Addresses

Primary practice location

3204 Archdale Rd
Archdale, NC 27263-2710

Mailing address

3204 Archdale Rd
Archdale, NC 27263-2710
Phone (336) 434-2107

Other names 1

  • Dr. Sydney Blair Stroud Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210408000095 NC Practitioner - Chiropractic 4183031248 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stroud Chiropractic PLLCGroup PAC ID 1153645288, 2 clinicians

Practice addresses (Care Compare)

3204 Archdale Rd
Archdale, NC 27263-2710
Phone (336) 434-2107

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5304NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Stroud Chiropractic PLLC Chiropractor CurrentSince Mar 31, 2021 Accepting new patients

Locations

3204 Archdale Rd
Archdale, NC 27263
Phone (336) 434-2107

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1617148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1467030460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3204 ARCHDALE RD",
            "city": "ARCHDALE",
            "state": "NC",
            "postal_code": "272632710",
            "telephone_number": "336-434-2107",
            "fax_number": "336-434-2109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3204 ARCHDALE RD",
            "city": "ARCHDALE",
            "state": "NC",
            "postal_code": "272632710",
            "telephone_number": "336-434-2107",
            "fax_number": "336-434-2109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASSITER",
        "first_name": "SYDNEY",
        "middle_name": "STROUD",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-31",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "5304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SYDNEY",
            "last_name": "STROUD",
            "middle_name": "BLAIR",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Archdale, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.