Lake Norman Chiropractic Center

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

LAKE NORMAN CHIROPRACTIC CENTER

Practice address

612 N Main St
Mooresville, NC 28115-2312

Phone

(704) 664-3455

Fax

(704) 664-2827

NPI assigned

Jun 20, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Todd Fulton Abernathy, D.C., C.C.S.P.NPI 1982696001

Title

President

Phone

(704) 664-3455

Specialties & licenses 2

Addresses

Other identifiers 12

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Tax ID family

Lake Norman Chiropractic Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Lake Norman Chiropractic Center, PA

  • Chiropractor
  • Mooresville, NC
  • NPI 1669894457
  NPD tax ID

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Todd Fulton Abernathy, D.C.

  • Sports Physician Chiropractor
  • Mooresville, NC
  • NPI 1982696001
  Medicare reassignment NPD Authorized official
• Robert A Combs III, DC

  • Chiropractor
  • Harrisburg, NC
  • NPI 1417435322
  NPD (past)
• Caleb S Kirby I, DC

  • Chiropractor
  • Mooresville, NC
  • NPI 1134653413
  NPD (past)
• Daniel P Zagst, D.C.

  • Chiropractor
  • Mooresville, NC
  • NPI 1093012692
  NPD (past)

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317859200000",
    "number": "1801832811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 N MAIN ST",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281152312",
            "telephone_number": "704-664-3455",
            "fax_number": "704-664-2827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 N MAIN ST",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281152312",
            "telephone_number": "704-664-3455",
            "fax_number": "704-664-2827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE NORMAN CHIROPRACTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-20",
        "last_updated": "2011-10-06",
        "status": "A",
        "authorized_official_last_name": "ABERNATHY",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "FULTON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-664-3455",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C., C.C.S.P."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIVIDUAL",
            "identifier": "085A6",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WAUSAU",
            "identifier": "42162996",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN",
            "identifier": "617420",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AWHN",
            "identifier": "53164",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "350053151",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7741266",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CNC (BCBS)",
            "identifier": "0194L",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUAILCHOICE",
            "identifier": "208640",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS INDIVIDUAL",
            "identifier": "43954",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS GROUP",
            "identifier": "4881",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PAL",
            "identifier": "5909823002",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89085A6",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patrick Jacques Laguerre, M.D.
• Lake Breeze ENT & Allergy PC
• Lake Norman Anesthesia Associates
• Lake Norman Bariatrics
• Lake Norman Child and Adolescent Psychiatry
• Lake Norman Chiropractic Center, PA
• Lake Norman Communication Services, Inc.
• Lake Norman Compounding Pharmacy, Inc.
• Lake Norman Cosmetic and Restorative Dentistry
• Lake Norman Counseling & Pastoral Care Center

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2011; 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.