Back to Health CMC Inc – Chiropractor in Durham, NC

Key facts

NPI: 1508932948
Entity type: Organization (NPI type 2)
Primary specialty: Chiropractor 111N00000X
License: 2687 (NC)
Legal business name: BACK TO HEALTH CMC INC
Practice address: 6224 Fayetteville Rd
Suite 106B
Durham, NC 27713-6288
Phone: (919) 544-8881
Fax: (919) 544-8889
NPI assigned: Nov 28, 2006
Organization subpart: No

Authorized official

Name: Dr. Kenneth Brown, DC NPI 1770659195
Title: President
Phone: (919) 544-8881

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 3

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

Kenneth Leonuse Brown, DC Chiropractor · Durham, NC · NPI 1770659195

Medicare reassignment NPD Authorized official CHIROPRACTOR · NC
Aqeila Shepherd, DC Chiropractor · Durham, NC · NPI 1326511197

NPD (past) CHIROPRACTOR
Teresa Paige Echols, DC Chiropractor · Huntsville, AL · NPI 1699459859

NPD (past) CHIROPRACTOR

Medicare participation

Medicare fee-for-service enrollment: Enrolled in NC

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20110928000226	NC	Part B Supplier - Clinic/Group Practice	1052582848	Receives reassigned benefits from 1 practitioner Practice locations: Durham, NC

National Provider Directory

Locations

6224 Fayetteville Rd
Ste 106B
Durham, NC 27713
Phone (919) 544-8881

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Chiropractor Group: 193400000X SINGLE SPECIALTY GROUP	111N00000X	2687	NC	Yes

Addresses

Primary practice location

6224 Fayetteville Rd
Suite 106B
Durham, NC 27713-6288

Mailing address

PO Box 52148
Durham, NC 27717-2148
Phone (919) 544-8881

Other identifiers

Identifier	Type	State	Issuer
085FR	Other	NC	BCBS
621714	Other	NC	ACN
621714	Other	NC	CIGNA
085FR	Other	NC	CNC
890839W	Medicaid	NC
621714	Other	NC	UNITED HEALTH CARE

Other names

Back To Health INC Former legal business name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508932948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52148",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277172148",
            "telephone_number": "919-544-8881",
            "fax_number": "919-544-8889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6224 FAYETTEVILLE RD",
            "address_2": "SUITE 106B",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277136288",
            "telephone_number": "919-544-8881",
            "fax_number": "919-544-8889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK TO HEALTH CMC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-544-8881",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "085FR",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN",
            "identifier": "621714",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "621714",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CNC",
            "identifier": "085FR",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890839W",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "621714",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Back To Health INC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Durham, NC

All providers in Durham, NC · Chiropractor in North Carolina

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider 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.