Individual provider Active NPI

Fotine Sophia Myers, D.C.

  • Chiropractor
  • Raleigh, NC
National Provider Identifier
1538222179
Registry record updated Sep 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2500 Issued in NC
Practice address
5041 Six Forks Rd
Ste: 105
Raleigh, NC 27609-4493
Phone
(919) 848-6188
Fax
(919) 848-6199
NPI assigned
Dec 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2500 NC Primary

Addresses

Primary practice location

5041 Six Forks Rd
Ste: 105
Raleigh, NC 27609-4493

Mailing address

5041 Six Forks Rd
Ste: 105
Raleigh, NC 27609-4493
Phone (919) 786-9996

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121204000121 NC Practitioner - Chiropractic 2567614282 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1997
Medicare assignment
May accept Medicare assignment
Group practices
Care Chiropractic PCGroup PAC ID 8820240773, 2 clinicians

Practice addresses (Care Compare)

5041 Six Forks Rd
Suite 105
Raleigh, NC 27609-4493
Phone (919) 786-9996

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2500NCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Care Chiropractic PC Chiropractor CurrentSince Jan 1, 2012 Accepting new patients

Locations

5041 Six Forks Rd
Ste 105
Raleigh, NC 27609
Phone (919) 786-9996

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380067200000",
    "number": "1538222179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5041 SIX FORKS RD",
            "address_2": "STE: 105",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276094493",
            "telephone_number": "919-786-9996",
            "fax_number": "919-786-9676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5041 SIX FORKS RD",
            "address_2": "STE: 105",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276094493",
            "telephone_number": "919-848-6188",
            "fax_number": "919-848-6199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "FOTINE",
        "middle_name": "SOPHIA",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2013-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2500",
            "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 Sep 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.