Conover Chiropractic Center PA
Organization Active NPI Orthopedic Chiropractor · Conover, NC
NPI 1609976497 · NPPES record last updated Nov 12, 2009
Key facts
- NPI
- 1609976497
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Orthopedic Chiropractor 111NX0800X
- License
- 1387 (NC)
- Legal business name
- CONOVER CHIROPRACTIC CENTER PA
- Practice address
- 408 1St Ave S
Conover, NC 28613-2704 - Phone
- (828) 464-7791
- Fax
- (828) 465-4062
- NPI assigned
- Sep 22, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Richard Kearns Davis Jr., DC
- Title
- President
- Phone
- (828) 464-7791
Practitioners 3
-
Eric Nathan Goans, D.C.
-
Ryan Craig Gutz, DC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050803000641 | NC | Part B Supplier - Clinic/Group Practice | 6002844628 |
Receives reassigned benefits from 3 practitioners Practice locations: Conover, NC |
National Provider Directory
Locations
408 1st Ave S
Conover, NC 28613
Phone (828) 464-7791
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Chiropractor |
111NX0800X | 1387 | NC | Yes |
Addresses
Primary practice location
408 1St Ave S
Conover, NC 28613-2704
Mailing address
408 1St Ave S
Conover, NC 28613-2704
Phone (828) 464-7791
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 08341 | Other | NC | BLUE CROSS |
| 8908341 | Medicaid | NC | |
| 1609976497 | Medicaid | NC |
Other providers in Conover, NC
- Marcus Henry Colon
- Barbara A Colosimo
- Comfort Cove Business LLC
- Compassionate Care Counseling, PLLC
- Compounding Specalties of Conover
- Conover Drug Company Inc
- Ashley Minton Cooper
- Larry Cooper
- Matthew Cooper
- Veronica M Corcino
All providers in Conover, NC · Orthopedic Chiropractor in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 12, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.