Mallard Creek Chiropractic Group

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1819 Issued in NC

Legal business name

MALLARD CREEK CHIROPRACTIC GROUP

Practice address

1905 JN Pease Place
Suite 204
Charlotte, NC 28262

Phone

(704) 593-0031

Fax

(704) 593-0058

NPI assigned

Oct 10, 2006

Organization subpart

No

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

Authorized official

Name

Mark Everett Brown, DCNPI 1538111349

Title

Doctor of Chiropractic President

Phone

(704) 593-0031

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark Everett Brown, DC

  • Chiropractor
  • Charlotte, NC
  • NPI 1538111349
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609964535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 JN PEASE PLACE",
            "address_2": "SUITE 204",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28262",
            "telephone_number": "704-593-0031",
            "fax_number": "704-593-0058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 JN PEASE PLACE",
            "address_2": "SUITE 204",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28262",
            "telephone_number": "704-593-0031",
            "fax_number": "704-593-0058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALLARD CREEK CHIROPRACTIC GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "EVERETT",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC PRESIDENT",
        "authorized_official_telephone_number": "704-593-0031",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "1819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pooja Malhotra, MD
• Dena Marie Malia, OTR/L
• Emma Grace Malinowski, LCSWA
• Karen Leigh Malizia
• Meghan H Malka, RD
• Mallard Creek Family Dentistry LLP
• Mallard Creek Learning Center
• Mallard Creek Therapeutic Services
• Michelle Parker Mallen, M.S, CCC-SLP
• Michelle Mallery Patel, BS

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.