Individual provider Active NPI

Jeffrey E Payne, DC

  • Chiropractor
  • Statesville, NC
National Provider Identifier
1699726679
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1997 Issued in NC
Practice address
126 S Tradd St
Statesville, NC 28677-5863
Phone
(704) 838-0990
Fax
(704) 838-0678
NPI assigned
May 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1997 NC Primary

Addresses

Primary practice location

126 S Tradd St
Statesville, NC 28677-5863

Mailing address

215 W Broad St
Statesville, NC 28677-5259
Phone (704) 838-0990

Other identifiers 1

IdentifierTypeStateIssuer
6908707MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111216000193 NC Practitioner - Chiropractic 3476577198 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

215 A W Broad St
Statesville, NC 28677-5259
Phone (704) 838-0990

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Payne Chiropractic Center PA Chiropractor CurrentSince Feb 2, 1998 Accepting new patients

Locations

215 W Broad St
Statesville, NC 28677
Phone (704) 838-0990

215 W Broad St
Ste A
Statesville, NC 28677
Phone (704) 838-0990

126 S Tradd St
Statesville, NC 28677
Phone (704) 838-0990

Organizations & group practices 1

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": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699726679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 W BROAD ST",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286775259",
            "telephone_number": "704-838-0990",
            "fax_number": "704-838-0678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 S TRADD ST",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286775863",
            "telephone_number": "704-838-0990",
            "fax_number": "704-838-0678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "JEFFREY",
        "middle_name": "E",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "1997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6908707",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.