Jacksonville Chiropractic & Wellness

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2621 Issued in NC

Legal business name

JACKSONVILLE CHIROPRACTIC & WELLNESS

Practice address

1201 Gum Branch Rd
Jacksonville, NC 28540-5016

Phone

(910) 455-6696

NPI assigned

Feb 11, 2010

Organization subpart

No

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

Authorized official

Name

David J Taylor, D.C.NPI 1669535506

Title

Owner

Phone

(919) 738-1214

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Taylor, D.C.

  • Chiropractor
  • Goldsboro, NC
  • NPI 1669535506
  Medicare reassignment NPD Authorized official
• Joseph W Democko, DC

  • Chiropractor
  • Goldsboro, NC
  • NPI 1649241209
  NPD (past)

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

{
    "created_epoch": "1265846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280361600000",
    "number": "1487986782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 E ASH ST",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275304045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 GUM BRANCH RD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285405016",
            "telephone_number": "910-455-6696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSONVILLE CHIROPRACTIC & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-11",
        "last_updated": "2010-07-29",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-738-1214",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "2453394A",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890837V",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Iyani Jackson
• Karen F Jackson
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• Jacksonville Children'S and Multispecialty Clinic, PA
• Jacksonville Diagnostic Imaging LLC
• Jacksonville Digestive Diseases Clinic PA
• Jacksonville Family Medical Center, PLLC
• Jacksonville Family Medical Center, PLLC
• Jacksonville Obstetrics, Gynecology & Infertility, P.a.

• Chiropractor in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Chiropractor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2010; 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.