Individual provider Active NPI

Renee D. Gilmore, D.C.

  • Chiropractor
  • Charlotte, NC
National Provider Identifier
1548320484
Registry record updated Jun 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2491 Issued in NC
Practice address
5200 Park Rd Ste 126
Charlotte, NC 28209-3675
Phone
(704) 350-9990
Fax
(704) 303-9369
NPI assigned
Dec 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2491 NC Primary

Addresses

Primary practice location

5200 Park Rd Ste 126
Charlotte, NC 28209-3675

Mailing address

PO Box 19982
Charlotte, NC 28219-0982
Phone (704) 697-9818

Other identifiers 3

IdentifierTypeStateIssuer
0833MOtherNCCHIROPRACTIC NETWORK BCBS
01108OtherNCNC STATE HEALTH PLAN
8901108MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100304000710 NC Practitioner - Chiropractic 0143365973 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2491NCMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Beyond Chiropractic, PLLC Chiropractor CurrentSince Mar 18, 2008 Accepting new patients
Total Touch Chiropractic Wellness Center PA Chiropractor CurrentSince Sep 21, 1998 Accepting new patients
Total Touch Chiropractic Wellness Center,PA Chiropractor Past Accepting new patients

Locations

5200 Park Rd
Ste 126
Charlotte, NC 28209
Phone (704) 350-9990

119 S Trade St
Ste 108
Matthews, NC 28105
Phone (704) 350-9990

Organizations & group practices 3

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": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340755200000",
    "number": "1548320484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19982",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282190982",
            "telephone_number": "704-697-9818",
            "fax_number": "704-697-9812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 PARK RD STE 126",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093675",
            "telephone_number": "704-350-9990",
            "fax_number": "704-303-9369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILMORE",
        "first_name": "RENEE",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2012-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROPRACTIC NETWORK BCBS",
            "identifier": "0833M",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC STATE HEALTH PLAN",
            "identifier": "01108",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8901108",
            "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 Jun 27, 2012; 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.