Active NPI
Charles Wayne Dinwiddie, D.C.
- Chiropractor
- Louisville, KY
National Provider Identifier
1831158377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3056
- Practice address
- 5129 Acapolca Way
Louisville, KY 40219-2116 - Phone
- (502) 968-1775
- Fax
- (502) 968-1311
- NPI assigned
- Mar 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3056 | KY | Primary |
Addresses
Primary practice location
5129 Acapolca Way
Louisville, KY 40219-2116
Mailing address
5129 Acapolca Way
Louisville, KY 40219-2116
Phone (502) 968-1775
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051213000055 | KY | Practitioner - Chiropractic | 1153342647 | Practice locations: Louisville, KY |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Lincoln Chiropractic College, 1968
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
5129 Acapolca Way
Louisville, KY 40219-2116
Phone (502) 968-1775
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3056 | KY | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1831158377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5129 ACAPOLCA WAY",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402192116",
"telephone_number": "502-968-1775",
"fax_number": "502-968-1311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5129 ACAPOLCA WAY",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402192116",
"telephone_number": "502-968-1775",
"fax_number": "502-968-1311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DINWIDDIE",
"first_name": "CHARLES",
"middle_name": "WAYNE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "KY",
"license": "3056",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.