Individual provider Active NPI

Robert Anthony Cynowa Jr., D.C.

  • Chiropractor
  • Fort Mill, SC
National Provider Identifier
1801075106
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3408 Issued in SC
Practice address
1520 Onyx RDG Ste 101
Fort Mill, SC 29708-0007
Phone
(704) 899-5000
NPI assigned
Nov 2, 2007
Last updated
Jun 11, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3792 NC
Chiropractor 111N00000X 3408 SC Primary

Addresses

Primary practice location

1520 Onyx RDG Ste 101
Fort Mill, SC 29708-0007

Mailing address

1520 Onyx RDG Ste 101
Fort Mill, SC 29708-0007
Phone (704) 899-5000

Other practice location 1

3010 Monroe Rd
Suite 105
Charlotte, NC 28205-7532
Phone (704) 334-3761

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091215000533 SC Practitioner - Chiropractic 5496831323 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1520 Onyx RDG
Suite 101
Fort Mill, SC 29708-0007
Phone (803) 650-3770

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3792NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Wellness Chiropractic Chiropractor CurrentSince Jul 16, 2009 Accepting new patients
Walraven Chiropractic Chiropractor Past Accepting new patients
McArdle Family Chiropractic, PLLC Chiropractor Past Accepting new patients

Locations

1520 Onyx Rdg
Ste 101
Fort Mill, SC 29708
Phone (704) 899-5000

Organizations & group practices 3

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": "1193961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1801075106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 ONYX RDG STE 101",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297080007",
            "telephone_number": "704-899-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 ONYX RDG STE 101",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297080007",
            "telephone_number": "704-899-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3010 Monroe Rd",
            "address_2": "Suite 105",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282057532",
            "country_code": "US",
            "telephone_number": "704-334-3761",
            "fax_number": "704-334-3763",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CYNOWA",
        "first_name": "ROBERT",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-02",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "3792",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "3408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Mill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.