Pustaver Chiropractic Care PA

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

1509 Issued in NC

Legal business name

PUSTAVER CHIROPRACTIC CARE PA

Practice address

4213 Matthews Mint Hill Rd
Matthews, NC 28105-3634

Phone

(704) 573-2400

Fax

(704) 573-1070

NPI assigned

Dec 16, 2010

Organization subpart

No

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

Authorized official

Name

Lauren Shipman

Title

Treating Ca

Phone

(704) 573-2400

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 1

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

• Mark R Pustaver, D.C.

  • Neurology Chiropractor
  • Matthews, NC
  • NPI 1336144534

  NC

  Medicare reassignment NPD

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

{
    "created_epoch": "1292457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298332800000",
    "number": "1831492628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4213 MATTHEWS MINT HILL RD",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281053634",
            "telephone_number": "704-573-2400",
            "fax_number": "704-573-1070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4213 MATTHEWS MINT HILL RD",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281053634",
            "telephone_number": "704-573-2400",
            "fax_number": "704-573-1070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUSTAVER CHIROPRACTIC CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-16",
        "last_updated": "2011-02-22",
        "status": "A",
        "authorized_official_last_name": "SHIPMAN",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "TREATING CA",
        "authorized_official_telephone_number": "704-573-2400"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "NC",
            "license": "1509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5900047",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa S Prushik, LCSW
• Publix North Carolina LP
• Susanna Pudner, MS, CGC
• Allison Leigh Pullen, PA-C
• Pursuit of Healing Counseling and Coaching, PLLC
• Mark R Pustaver, D.C.
• Q.M. Chen, D.M.D., PH.D, P.a.
• QC House of Hope
• Katherine Quackenbush
• Jacqueline Quartuccio, LCSW

• All providers in Matthews, NC
• Preferred Provider Organization in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.