Organization Active NPI

Mary E Shafer DC PLLC

  • Chiropractor
  • Gastonia, NC
National Provider Identifier
1801447651
Registry record updated Sep 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
MARY E SHAFER DC PLLC
Doing business as
CHIROPRACTIC AT CWLI
Practice address
216 S New Hope Rd
Gastonia, NC 28054-4805
Phone
(269) 598-7603
NPI assigned
Sep 24, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2019

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

Authorized official

Name
Dr. Mary E Shafer, DCNPI 1679837660
Title
Owner/Member
Phone
(269) 598-7603

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

216 S New Hope Rd
Gastonia, NC 28054-4805

Mailing address

PO Box 463
Matthews, NC 28106-0463
Phone (269) 598-7603

Other names 1

  • CHIROPRACTIC AT CWLI Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200310000871 NC Part B Supplier - Clinic/Group Practice 5698102358 Receives reassigned benefits from 1 practitioner
Practice locations: Gastonia, NC

National Provider Directory

National Provider Directory

Locations

216 S New Hope Rd
Gastonia, NC 28054
Phone (269) 598-7603

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": "1569283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569283200000",
    "number": "1801447651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 463",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281060463",
            "telephone_number": "269-598-7603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 S NEW HOPE RD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280544805",
            "telephone_number": "269-598-7603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY E SHAFER DC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-24",
        "last_updated": "2019-09-24",
        "status": "A",
        "authorized_official_last_name": "SHAFER",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "269-598-7603",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHIROPRACTIC AT CWLI",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gastonia, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2019; 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.