Individual provider Active NPI

Nathan Ted Tracy, DC

  • Chiropractor
  • Lexington, NC
National Provider Identifier
1619463296
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4930 Issued in NC
Practice address
215 W US Highway 64
Lexington, NC 27295
Phone
(336) 243-5433
NPI assigned
Jul 6, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4930 NC Primary

Addresses

Primary practice location

215 W US Highway 64
Lexington, NC 27295

Mailing address

503 Ctr Way
Lexington, NC 27292
Phone (704) 780-2488

Other practice location 1

4600 Park Rd Ste 380
Charlotte, NC 28209-3666
Phone (704) 780-2488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4930NCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Freeman & Tracy Chiropractic Chiropractor CurrentSince Apr 30, 2023 Accepting new patients
Carolina Neuropathy Centers, PLLC CurrentSince Oct 31, 2021 Accepting new patients

Locations

4600 Park Rd
Ste 380
Charlotte, NC 28209
Phone (704) 236-8245

215 W US Highway 64
Ste 1
Lexington, NC 27295
Phone (336) 242-1125

Organizations & group practices 2

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": "1530835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1619463296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 CTR WAY",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "27292",
            "telephone_number": "704-780-2488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 W US HIGHWAY 64",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "27295",
            "telephone_number": "336-243-5433"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4600 Park Rd Ste 380",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282093666",
            "country_code": "US",
            "telephone_number": "704-780-2488",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRACY",
        "first_name": "NATHAN",
        "middle_name": "TED",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-06",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "4930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2023; 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.