Cherry Point Chiropractic & Rehabilitation Center PA

Organization Active NPI Chiropractor · Havelock, NC

NPI 1831149285 · NPPES record last updated May 2, 2016

Key facts

NPI
1831149285
Entity type
Organization (NPI type 2)
Primary specialty
Chiropractor 111N00000X
License
2801 (NC)
Legal business name
CHERRY POINT CHIROPRACTIC & REHABILITATION CENTER PA
Practice address
318 E Main St
Havelock, NC 28532-2214
Phone
(252) 444-3377
Fax
(252) 444-3529
NPI assigned
May 10, 2006
Organization subpart
No

Authorized official

Name
Dr. Russell Kelso Davis, DC ATC
Title
President Ceo
Phone
(252) 444-3377

Practitioners 3

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NC

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20100209000405 NC Part B Supplier - Clinic/Group Practice 2062555345 Receives reassigned benefits from 1 practitioner
Practice locations: Havelock, NC

National Provider Directory

Locations

318 E Main St
Havelock, NC 28532
Phone (252) 444-3377

314 US Highway 70 W
Havelock, NC 28532
Phone (252) 447-0991

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor
Group: 193200000X MULTI-SPECIALTY GROUP
111N00000X 2801 NC Yes

Addresses

Primary practice location

318 E Main St
Havelock, NC 28532-2214

Mailing address

318 E Main St
Havelock, NC 28532-2214
Phone (252) 444-3377

Other identifiers

IdentifierTypeStateIssuer
890844VMedicaidNC
7167352OtherAETNA
0844VOtherNCBLUE CROSS BLUE SHIELD

Other providers in Havelock, NC

All providers in Havelock, NC · Chiropractor in North Carolina

Sources for this page

Verify at the official NPI Registry.