Organization Active NPI

Kosterman Chiropractic Center, P.a.

  • Chiropractor
  • Clinton, NC
National Provider Identifier
1528127099
Registry record updated Jul 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
200001407900 Issued in NC
Legal business name
KOSTERMAN CHIROPRACTIC CENTER, P.A.
Practice address
401 Cooper Drive
Clinton, NC 28328-2898
Phone
(910) 592-2250
Fax
(910) 592-6149
NPI assigned
Dec 8, 2006
Organization subpart
Yes
Parent organization
KOSTERMAN CHIROPRACTIC CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2010

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

Authorized official

Name
Dr. Timothy Mark KostermanNPI 1396753646
Title
Vice President
Phone
(910) 592-2250

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 200001407900 NC Primary

Addresses

Primary practice location

401 Cooper Drive
Clinton, NC 28328-2898

Mailing address

401 Cooper Drive
Clinton, NC 28328-2898

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080503000011 NC Part B Supplier - Clinic/Group Practice 2961581855 Receives reassigned benefits from 1 practitioner
Practice locations: Clinton, NC

National Provider Directory

National Provider Directory
Part of
Kosterman Chiropractic Center PA

Locations

401 Cooper Dr
Clinton, NC 28328
Phone (910) 592-2250

Practitioners & affiliated clinicians

Practitioners 2

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": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279670400000",
    "number": "1528127099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 COOPER DRIVE",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283282898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 COOPER DRIVE",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283282898",
            "telephone_number": "910-592-2250",
            "fax_number": "910-592-6149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOSTERMAN CHIROPRACTIC CENTER, P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KOSTERMAN CHIROPRACTIC CENTER",
        "enumeration_date": "2006-12-08",
        "last_updated": "2010-07-21",
        "status": "A",
        "authorized_official_last_name": "KOSTERMAN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "910-592-2250",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "200001407900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.