Marcus Keith Woodburn

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4871 Issued in NC

Practice address

2013 Olde Regent Way Ste 170
Leland, NC 28451-4194

Phone

(910) 477-3661

NPI assigned

Apr 4, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Chiropractic

Education

Sherman College of Straight Chiropractic, 2017

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Greatest Potential Chiropractic LLC

  • Chiropractor
  • Leland, NC
  • NPI 1154827467
  Medicare reassignment NPD Authorized official
• Beachtown Chiropractic Co., LLC

  • Chiropractor
  • Panama City Beach, FL
  • NPI 1336625532
  NPD (past)

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

{
    "created_epoch": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522800000000",
    "number": "1548766827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 AIRPORT RD STE C",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "368305701",
            "telephone_number": "334-321-7275",
            "fax_number": "888-505-3765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2013 OLDE REGENT WAY STE 170",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "284514194",
            "telephone_number": "910-477-3661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODBURN",
        "first_name": "MARCUS",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-04",
        "last_updated": "2018-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "4871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Antoinette L Williams
• Wilmington Health PLLC
• Stacie Wilson, PHARMD
• Wise Way ABA LLC (Wise Way ABA)
• Jessica Ruth Wizman, LCSW
• Word of Life Ourtreach of Cape Fear, Inc.
• Word of Life Outeach, Inc
• Word of Life Outreach of Cape Fear Inc
• Word of Life Outreach of Cape Fear, Inc
• Word of Life Outreach of Cape Fear, Inc.

• Chiropractor in Leland, NC
• Providers in Leland, NC by specialty
• Chiropractor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2018; 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.