Pinecrest Chiropractic PLLC

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

Legal business name

PINECREST CHIROPRACTIC PLLC

Practice address

609 Attain St Ste 141
Fuquay Varina, NC 27526-1987

Phone

(330) 447-7234

NPI assigned

Oct 30, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Thomas Watt, DCNPI 1649868753

Title

Owner Operator

Phone

(330) 447-7234

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 2

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

• Thomas Watt, DC

  • Independent Medical Examiner Chiropractor
  • Fuquay Varina, NC
  • NPI 1649868753
  Medicare reassignment Care Compare group NPD Authorized official
• Michaela Berriault

  • Chiropractor
  • Fuquay Varina, NC
  • NPI 1699562488
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1635552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644969600000",
    "number": "1619631140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1621 KENDALL HILL RD",
            "city": "WILLOW SPRING",
            "state": "NC",
            "postal_code": "275929070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 ATTAIN ST STE 141",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275261987",
            "telephone_number": "330-447-7234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINECREST CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-30",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A",
        "authorized_official_last_name": "WATT",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER OPERATOR",
        "authorized_official_telephone_number": "330-447-7234",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bridget Ann Peterson, OTRL
• Alicia Ivana Peton, M.S., LCMHC
• Lori Johnson Petree, DDS
• Chante Dominique Pettiford, DPT
• Phoenix Partners NC
• Jordan Pittman
• Matthew Riggs Pittman
• Sophie Pittman
• Jennifer Shugars Podgurski, PA-C
• Tiarra Poindexter

• Sports Physician Chiropractor in Fuquay Varina, NC
• Providers in Fuquay Varina, 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 Feb 16, 2022; 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.