Individual provider Active NPI

Joseph Livingstone Glick III, D.C.

  • Chiropractor
  • Mooresville, NC
National Provider Identifier
1730830688
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5441 Issued in NC
Practice address
736 Brawley School Rd Ste E
Mooresville, NC 28117-9283
Phone
(704) 664-1031
Fax
(704) 664-1035
NPI assigned
Jan 12, 2022
Last updated
Oct 11, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5441 NC Primary

Addresses

Primary practice location

736 Brawley School Rd Ste E
Mooresville, NC 28117-9283

Mailing address

736 Brawley School Rd Ste E
Mooresville, NC 28117-9283
Phone (704) 664-1031

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230803003567 NC Practitioner - Chiropractic 2860853041 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5441NCMDAudiologist-Hearing Aid Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Chiropractic Care PLLC Chiropractor Current Accepting new patients
KDW Chirocare Inc Chiropractor CurrentSince May 22, 2023 Accepting new patients
100 Percent Chiropractic Padilla, LLC Chiropractor PastSince Jan 1, 2022 Accepting new patients
100 Chiropractic Hummel PLLC Chiropractor PastSince Dec 17, 2023 Accepting new patients

Locations

736 Brawley School Rd
Ste E
Mooresville, NC 28117
Phone (704) 662-0200

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1641945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1730830688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 BRAWLEY SCHOOL RD STE E",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281179283",
            "telephone_number": "704-664-1031",
            "fax_number": "704-664-1035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 BRAWLEY SCHOOL RD STE E",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281179283",
            "telephone_number": "704-664-1031",
            "fax_number": "704-664-1035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLICK",
        "first_name": "JOSEPH",
        "middle_name": "LIVINGSTONE",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-12",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "5441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.