Individual provider Active NPI

Michael Deverell Danaher, D.C.

  • Chiropractor
  • Cary, NC
National Provider Identifier
1730469412
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4206 Issued in NC
Practice address
539 Kiesler Drive
Suite 104
Cary, NC 27518
Phone
(919) 387-7220
NPI assigned
Aug 25, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4206 NC Primary

Addresses

Primary practice location

539 Kiesler Drive
Suite 104
Cary, NC 27518

Mailing address

539 Kiesler Drive
Suite 104
Cary, NC 27518
Phone (919) 387-7220

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111019000175 NC Practitioner - Chiropractic 2466624325 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4206NCMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Mudryk Family Chiropractic, PA CurrentSince Apr 20, 2021 Accepting new patients
Carolina Joint and Spine, PLLC Chiropractor Past Accepting new patients

Locations

539 Keisler Dr
Ste 104
Cary, NC 27518
Phone (919) 387-7220

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.

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National Medical University, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mudryk Family Chiropractic PA 2 clinicians

Practice addresses (Care Compare)

539 Keisler Dr
Suite 104
Cary, NC 27518-9320
Phone (919) 387-7220

NPI Registry JSON

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

{
    "created_epoch": "1314230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1730469412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "539 KIESLER DRIVE",
            "address_2": "SUITE 104",
            "city": "CARY",
            "state": "NC",
            "postal_code": "27518",
            "telephone_number": "919-387-7220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "539 KIESLER DRIVE",
            "address_2": "SUITE 104",
            "city": "CARY",
            "state": "NC",
            "postal_code": "27518",
            "telephone_number": "919-387-7220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANAHER",
        "first_name": "MICHAEL",
        "middle_name": "DEVERELL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-25",
        "last_updated": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "4206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; 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.