Individual provider Active NPI

Sara Beth Stroud, DC

  • Chiropractor
  • Jacksonville, NC
National Provider Identifier
1679864326
Registry record updated Apr 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4166 Issued in NC
Practice address
445 Western Blvd
Suite O
Jacksonville, NC 28546-6845
Phone
(910) 238-2330
Fax
(910) 238-2320
NPI assigned
Apr 29, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4166 NC Primary

Addresses

Primary practice location

445 Western Blvd
Suite O
Jacksonville, NC 28546-6845

Mailing address

PO Box 12559
Jacksonville, NC 28546-2559
Phone (910) 238-2330

Other identifiers 1

IdentifierTypeStateIssuer
5919473MedicaidNC

Other names 1

  • Sara Beth Heath Former name

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
4166NCMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Freedom Chiropractic, PLLC Chiropractor CurrentSince Oct 1, 2012 Accepting new patients
Family First Chiropractic Inc Chiropractor PastSince Jul 30, 2012 Accepting new patients
Blue Ridge Health and Spine, PLLC Chiropractor PastSince Sep 3, 2016 Accepting new patients

Locations

445 Western Blvd
Ste O
Jacksonville, NC 28546
Phone (910) 238-2330

Organizations & group practices 3

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": "1304035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493164800000",
    "number": "1679864326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12559",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285462559",
            "telephone_number": "910-238-2330",
            "fax_number": "910-238-2320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 WESTERN BLVD",
            "address_2": "SUITE O",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466845",
            "telephone_number": "910-238-2330",
            "fax_number": "910-238-2320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STROUD",
        "first_name": "SARA",
        "middle_name": "BETH",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-29",
        "last_updated": "2017-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "4166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5919473",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARA",
            "last_name": "HEATH",
            "middle_name": "BETH",
            "credential": "DC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2017; 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.