Individual provider Active NPI

Samuel Elliott, DC

  • Chiropractor
  • Morganton, NC
National Provider Identifier
1649365453
Registry record updated Apr 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2895 Issued in NC
Practice address
300 N Terrace PL
Morganton, NC 28655-3753
Phone
(828) 438-1153
Fax
(828) 438-1162
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2895 NC Primary

Addresses

Primary practice location

300 N Terrace PL
Morganton, NC 28655-3753

Mailing address

300 N Terrace PL
Morganton, NC 28655-3753
Phone (828) 438-1153

Other identifiers 3

IdentifierTypeStateIssuer
890849KMedicaidNC
0849KOtherNCBCBS
0849KOtherNCCNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040916000921 NC Practitioner - Chiropractic 3173590239 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

300 N Terrace PL
Morganton, NC 28655-3753
Phone (828) 438-1153

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2895NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cold Water Counseling PLLC CurrentSince Oct 1, 2023 Accepting new patients
Elliott Chiropractic Center PA Chiropractor CurrentSince Aug 2, 2004 Accepting new patients

Locations

300 N Terrace Pl
Morganton, NC 28655
Phone (704) 765-2059

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335744000000",
    "number": "1649365453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N TERRACE PL",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286553753",
            "telephone_number": "828-438-1153",
            "fax_number": "828-438-1162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N TERRACE PL",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286553753",
            "telephone_number": "828-438-1153",
            "fax_number": "828-438-1162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "SAMUEL",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2012-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890849K",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0849K",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CNC",
            "identifier": "0849K",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morganton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.