NPIMap

Organization Active NPI

Chavis Chiropractic Clinic of Monroe, P.a.

  • Medical Specialty Clinic/Center
  • Indian Trail, NC
National Provider Identifier
1790919637
Registry record updated Feb 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
3103 Issued in NC
Legal business name
CHAVIS CHIROPRACTIC CLINIC OF MONROE, P.A.
Practice address
1518 Saratoga Blvd
Indian Trail, NC 28079-5749
Phone
(704) 628-0378
Fax
(704) 282-0317
NPI assigned
May 6, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2011

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

Authorized official

Name
Dr. Matthew Chavis, D.C.
Title
President
Phone
(704) 283-5599

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 3103 NC Primary

Addresses

Primary practice location

1518 Saratoga Blvd
Indian Trail, NC 28079-5749

Mailing address

2204 W Roosevelt Blvd
Monroe, NC 28110-2762
Phone (704) 283-5599

Other identifiers 3

IdentifierTypeStateIssuer
085M6OtherNCBLUE CROSS/BLUE SHIELD
2455493BOtherNCMEDICARE
89085M6MedicaidNC

National Provider Directory

National Provider Directory

Locations

2204 W Roosevelt Blvd
Monroe, NC 28110
Phone (704) 283-5599

Practitioners & affiliated clinicians

Practitioners 1

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": "1241568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296604800000",
    "number": "1790919637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2204 W ROOSEVELT BLVD",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281102762",
            "telephone_number": "704-283-5599",
            "fax_number": "704-282-0317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1518 SARATOGA BLVD",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "280795749",
            "telephone_number": "704-628-0378",
            "fax_number": "704-282-0317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAVIS CHIROPRACTIC CLINIC OF MONROE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-06",
        "last_updated": "2011-02-02",
        "status": "A",
        "authorized_official_last_name": "CHAVIS",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-283-5599",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NC",
            "license": "3103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "085M6",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "2455493B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89085M6",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indian Trail, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2011; 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.