Active NPI
Dillan Jay Bollwinkel, DC
- Chiropractor
- Raleigh, NC
National Provider Identifier
1528689643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 5184
- Practice address
- 3410 Six Forks Rd
Raleigh, NC 27609-7234 - Phone
- (919) 832-3365
- NPI assigned
- Apr 29, 2020
- Last updated
- Apr 29, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 5184 | NC | Primary |
Addresses
Primary practice location
3410 Six Forks Rd
Raleigh, NC 27609-7234
Mailing address
3410 Six Forks Rd
Raleigh, NC 27609-7234
Phone (919) 832-3365
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5184 | NC | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588118400000",
"number": "1528689643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3410 SIX FORKS RD",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276097234",
"telephone_number": "919-832-3365"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3410 SIX FORKS RD",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276097234",
"telephone_number": "919-832-3365"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLLWINKEL",
"first_name": "DILLAN",
"middle_name": "JAY",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-04-29",
"last_updated": "2020-04-29",
"certification_date": "2020-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Chiropractor",
"state": "NC",
"license": "5184",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.