Organization Active NPI

Chiropractic Health and Wellness Center, P. a.

  • Chiropractor
  • Fayetteville, NC
National Provider Identifier
1710150016
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2691 Issued in NC
Legal business name
CHIROPRACTIC HEALTH AND WELLNESS CENTER, P. A.
Practice address
5414 Yadkin Rd
Fayetteville, NC 28303-3199
Phone
(910) 487-5010
Fax
(910) 487-3919
NPI assigned
Apr 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2008

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

Authorized official

Name
Dr. David Henry Fonke, D.C.NPI 1316955628
Title
President
Phone
(910) 487-5010

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2691 NC Primary

Addresses

Primary practice location

5414 Yadkin Rd
Fayetteville, NC 28303-3199

Mailing address

5414 Yadkin Rd
Fayetteville, NC 28303-3199
Phone (910) 487-5010

Other identifiers 2

IdentifierTypeStateIssuer
890836UMedicaidNC
0836UOtherNCBCBS

National Provider Directory

National Provider Directory

Locations

5414 Yadkin Rd
Fayetteville, NC 28303
Phone (910) 487-5010

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211241600000",
    "number": "1710150016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5414 YADKIN RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283033199",
            "telephone_number": "910-487-5010",
            "fax_number": "910-487-3919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5414 YADKIN RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283033199",
            "telephone_number": "910-487-5010",
            "fax_number": "910-487-3919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC HEALTH AND WELLNESS CENTER, P. A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-08",
        "last_updated": "2008-05-20",
        "status": "A",
        "authorized_official_last_name": "FONKE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "HENRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-487-5010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890836U",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0836U",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; 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.