Organization Active NPI

Osborne Chiropractic Clinic LL PA

  • Chiropractor
  • Rolesville, NC
National Provider Identifier
1487671970
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2871 Issued in NC
Legal business name
OSBORNE CHIROPRACTIC CLINIC LL PA
Practice address
258 Southtown Circle
Rolesville, NC 27571
Phone
(919) 569-0199
Fax
(919) 783-7835
NPI assigned
Jul 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Bryan Carl Osborne, DCNPI 1518985803
Title
Owner President
Phone
(919) 569-0199

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 2871 NC Primary

Addresses

Primary practice location

258 Southtown Circle
Rolesville, NC 27571

Mailing address

258 Southtown Circle
Rolesville, NC 27571
Phone (919) 569-0199

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070425000163 NC Part B Supplier - Clinic/Group Practice 0042315780 Receives reassigned benefits from 3 practitioners
Practice locations: Rolesville, NC

National Provider Directory

National Provider Directory

Locations

258 Southtown Cir
Rolesville, NC 27571
Phone (919) 435-1185

Practitioners & affiliated clinicians

Practitioners 6

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": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487671970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 SOUTHTOWN CIRCLE",
            "city": "ROLESVILLE",
            "state": "NC",
            "postal_code": "27571",
            "telephone_number": "919-569-0199",
            "fax_number": "919-783-7835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 SOUTHTOWN CIRCLE",
            "city": "ROLESVILLE",
            "state": "NC",
            "postal_code": "27571",
            "telephone_number": "919-569-0199",
            "fax_number": "919-783-7835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSBORNE CHIROPRACTIC CLINIC LL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OSBORNE",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "CARL",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "919-569-0199",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rolesville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.