NPIMap

Organization Active NPI

In Home Chiropractic & Personal Training

  • Chiropractor
  • Charlotte, NC
National Provider Identifier
1497087035
Registry record updated Oct 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3802 Issued in NC
Legal business name
IN HOME CHIROPRACTIC & PERSONAL TRAINING
Practice address
500 E Morehead St
Suite 216
Charlotte, NC 28202-2616
Phone
(704) 295-1641
Fax
(704) 295-1498
NPI assigned
Feb 8, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2010

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

Authorized official

Name
Daren Z Bethea II, DCNPI 1760492482
Title
Owner
Phone
(704) 295-1641

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 3802 NC Primary

Addresses

Primary practice location

500 E Morehead St
Suite 216
Charlotte, NC 28202-2616

Mailing address

68 Global Dr
Suite 100
Greenville, SC 29607-4628
Phone (864) 644-2700

Other identifiers 1

IdentifierTypeStateIssuer
3802OtherNCDC LICENSE

National Provider Directory

National Provider Directory

Locations

500 E Morehead St
Ste 216
Charlotte, NC 28202
Phone (704) 295-1641

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": "1265587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288224000000",
    "number": "1497087035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 GLOBAL DR",
            "address_2": "SUITE 100",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296074628",
            "telephone_number": "864-644-2700",
            "fax_number": "864-644-2709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E MOREHEAD ST",
            "address_2": "SUITE 216",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022616",
            "telephone_number": "704-295-1641",
            "fax_number": "704-295-1498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IN HOME CHIROPRACTIC & PERSONAL TRAINING",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-08",
        "last_updated": "2010-10-28",
        "status": "A",
        "authorized_official_last_name": "BETHEA",
        "authorized_official_first_name": "DAREN",
        "authorized_official_middle_name": "Z",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-295-1641",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "3802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DC LICENSE",
            "identifier": "3802",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.