Jeff W Lissenden, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1894 Issued in NC

Practice address

1320 SE Maynard Rd
Suite 102
Cary, NC 27511

Phone

(919) 650-2700

Fax

(919) 650-1267

NPI assigned

Aug 17, 2006

Last updated

Nov 25, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Christopher Pawlicki DC, PC

  • Chiropractor
  • Cary, NC
  • NPI 1801769146
  NPD

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1770696031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 SE MAYNARD RD",
            "address_2": "SUITE 102",
            "city": "CARY",
            "state": "NC",
            "postal_code": "27511",
            "telephone_number": "919-650-2700",
            "fax_number": "919-650-1267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 SE MAYNARD RD",
            "address_2": "SUITE 102",
            "city": "CARY",
            "state": "NC",
            "postal_code": "27511",
            "telephone_number": "919-650-2700",
            "fax_number": "919-650-1267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISSENDEN",
        "first_name": "JEFF",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "1894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "085XH",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN",
            "identifier": "609865",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Cary, NC
• Providers in Cary, NC by specialty
• Chiropractor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; 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.