Mazyar Neshat, D.C.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

2976 Issued in NC

Practice address

1001 Van Buren Ave Ste E
Indian Trail, NC 28079-5584

Phone

(704) 882-2255

Fax

(704) 882-2252

NPI assigned

Sep 13, 2006

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

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Mazyar Michael Neshat, D.C., P.a.

  dba Maz Clinic of Chiropractic

  • Sports Physician Chiropractor
  • Indian Trail, NC
  • NPI 1912002007
  NPD Authorized official

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254787200000",
    "number": "1609971878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 VAN BUREN AVE STE E",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "280795584",
            "telephone_number": "704-882-2255",
            "fax_number": "704-882-2252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 VAN BUREN AVE STE E",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "280795584",
            "telephone_number": "704-882-2255",
            "fax_number": "704-882-2252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NESHAT",
        "first_name": "MAZYAR",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2009-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "NC",
            "license": "2976",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "085EA",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "618261",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89085EA",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "618261",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Jessica Elaine O'Shields, LMFT

• Sports Physician Chiropractor in Indian Trail, NC
• Providers in Indian Trail, NC by specialty
• Sports Physician Chiropractor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.