Individual provider Active NPI

Daniel Reed Mudryk, D.C.

  • Chiropractor
  • Cary, NC
National Provider Identifier
1831139948
Registry record updated Apr 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3203 Issued in NC
Practice address
539 Keisler Dr
Suite 104
Cary, NC 27518-9320
Phone
(919) 387-7220
Fax
(919) 387-8121
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3203 NC Primary

Addresses

Primary practice location

539 Keisler Dr
Suite 104
Cary, NC 27518-9320

Mailing address

539 Keisler Dr
Suite 104
Cary, NC 27518-9320
Phone (919) 387-7220

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031216000353 NC Practitioner - Chiropractic 2466359617 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mudryk Family Chiropractic PAGroup PAC ID 0042237083, 2 clinicians

Practice addresses (Care Compare)

539 Keisler Dr
Suite 104
Cary, NC 27518-9320
Phone (919) 387-7220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3203NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mudryk Family Chiropractic, PA CurrentSince Nov 1, 2003 Accepting new patients

Locations

539 Keisler Dr
Ste 104
Cary, NC 27518
Phone (919) 387-7220

Interoperability endpoints

  • Direct secure messaging: daniel.mudryk@direct.mudrykchiro.nchie.net

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461628800000",
    "number": "1831139948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "539 KEISLER DR",
            "address_2": "SUITE 104",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275189320",
            "telephone_number": "919-387-7220",
            "fax_number": "919-387-8121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "539 KEISLER DR",
            "address_2": "SUITE 104",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275189320",
            "telephone_number": "919-387-7220",
            "fax_number": "919-387-8121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUDRYK",
        "first_name": "DANIEL",
        "middle_name": "REED",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2016-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "3203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2016; 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.