Individual provider Active NPI

Darian Justin Smith, D.C.

  • Chiropractor
  • Kernersville, NC
National Provider Identifier
1609072859
Registry record updated Dec 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3796 Issued in NC
Practice address
127 N Main St
Kernersville, NC 27284-2815
Phone
(336) 996-2462
Fax
(336) 996-9878
NPI assigned
Jun 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3796 NC Primary

Addresses

Primary practice location

127 N Main St
Kernersville, NC 27284-2815

Mailing address

127 N Main St
Kernersville, NC 27284-2815
Phone (336) 996-2462

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080326000973 NC Practitioner - Chiropractic 6204912587 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

127 N Main St
Kernersville, NC 27284-2815
Phone (336) 996-2462

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3796NCMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kernersville Chiropractic Center Chiropractor CurrentSince Jan 15, 2018 Accepting new patients

Locations

127 N Main St
Kernersville, NC 27284
Phone (336) 996-2462

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": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197590400000",
    "number": "1609072859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 N MAIN ST",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272842815",
            "telephone_number": "336-996-2462",
            "fax_number": "336-996-9878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 N MAIN ST",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272842815",
            "telephone_number": "336-996-2462",
            "fax_number": "336-996-9878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DARIAN",
        "middle_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-25",
        "last_updated": "2007-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "3796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kernersville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2007; 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.