Individual provider Active NPI

Joseph Criscuola, D.C.

  • Chiropractor
  • Wake Forest, NC
National Provider Identifier
1831217363
Registry record updated Sep 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3684 Issued in NC
Practice address
2824 Rogers Rd
Suite 204
Wake Forest, NC 27587-3895
Phone
(919) 453-0367
NPI assigned
Mar 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3684 NC Primary

Addresses

Primary practice location

2824 Rogers Rd
Suite 204
Wake Forest, NC 27587-3895

Mailing address

2824 Rogers Rd
Suite 204
Wake Forest, NC 27587-3895
Phone (919) 453-0367

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070926000877 NC Practitioner - Chiropractic 3072608702 Practice locations: Wake Forest, NC

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3684NCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Kim R. Melton, DDS, PHD, P.a. Past Accepting new patients
Lane and Associates LV DDS PA PastSince Dec 22, 2024 Accepting new patients

Organizations & group practices 2

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": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315267200000",
    "number": "1831217363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2824 ROGERS RD",
            "address_2": "SUITE 204",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275873895",
            "telephone_number": "919-453-0367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2824 ROGERS RD",
            "address_2": "SUITE 204",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275873895",
            "telephone_number": "919-453-0367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISCUOLA",
        "first_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2011-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "3684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wake Forest, NC

Sources for this page

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