NPIMap

Organization Active NPI

Carolina Upper Cervical Clinic, Inc.

  • Chiropractor
  • Charlotte, NC
National Provider Identifier
1497796890
Registry record updated Mar 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2039 Issued in NC
Legal business name
CAROLINA UPPER CERVICAL CLINIC, INC.
Practice address
2550 W Arrowood Rd
Ste. 104
Charlotte, NC 28273-6651
Phone
(704) 588-5560
Fax
(704) 588-4919
NPI assigned
Jun 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2008

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

Authorized official

Name
Dr. Ray Todd Drury, DCNPI 1457398174
Title
President
Phone
(704) 588-5560

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 2039 NC Primary

Addresses

Primary practice location

2550 W Arrowood Rd
Ste. 104
Charlotte, NC 28273-6651

Mailing address

2550 W Arrowood Rd
Ste. 104
Charlotte, NC 28273-6651
Phone (704) 588-5560

Other identifiers 3

IdentifierTypeStateIssuer
DA9966OtherNCRAILROAD CORPORATION ID #
015AXOtherNCBCBSNC CORPORATION ID #
89015AXMedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070609000148 NC Part B Supplier - Clinic/Group Practice 3779497425 Receives reassigned benefits from 1 practitioner
Practice locations: Charlotte, NC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204675200000",
    "number": "1497796890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 W ARROWOOD RD",
            "address_2": "STE. 104",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282736651",
            "telephone_number": "704-588-5560",
            "fax_number": "704-588-4919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 W ARROWOOD RD",
            "address_2": "STE. 104",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282736651",
            "telephone_number": "704-588-5560",
            "fax_number": "704-588-4919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA UPPER CERVICAL CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2008-03-05",
        "status": "A",
        "authorized_official_last_name": "DRURY",
        "authorized_official_first_name": "RAY",
        "authorized_official_middle_name": "TODD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-588-5560",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2039",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD CORPORATION ID #",
            "identifier": "DA9966",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC  CORPORATION ID #",
            "identifier": "015AX",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89015AX",
            "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 Mar 5, 2008; 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.