Organization Active NPI

Permenter Chiropractic, Inc.

  • Chiropractor
  • Charlotte, NC
National Provider Identifier
1851496434
Registry record updated Jan 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2671 Issued in NC
Legal business name
PERMENTER CHIROPRACTIC, INC.
Practice address
9123 Monroe Rd Ste 100
Charlotte, NC 28270-2456
Phone
(704) 569-3130
Fax
(704) 569-9797
NPI assigned
Sep 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2022

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

Authorized official

Name
Dr. Thomas Jason Permenter, DCNPI 1164422192
Title
Ceo
Phone
(704) 569-3130

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2671 NC Primary

Addresses

Primary practice location

9123 Monroe Rd Ste 100
Charlotte, NC 28270-2456

Mailing address

9123 Monroe Rd Ste 100
Charlotte, NC 28270-2456
Phone (704) 569-3130

Other identifiers 7

IdentifierTypeStateIssuer
963043003OtherNCCIGNA
790838FMedicaidNC
0838FOtherNCBCBS
7572054OtherNCAETNA - PPO
2117085094101OtherNCBEECH STREET
3467419OtherNCAETNA - HMO
606834-980061OtherNCACN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070928000594 NC Part B Supplier - Clinic/Group Practice 4385737105 Receives reassigned benefits from 1 practitioner
Practice locations: Charlotte, NC

National Provider Directory

National Provider Directory

Locations

9123 Monroe Rd
Ste 100
Charlotte, NC 28270
Phone (704) 569-3130

2301 Village Lake Dr
Charlotte, NC 28212
Phone (704) 569-3130

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642636800000",
    "number": "1851496434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9123 MONROE RD STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282702456",
            "telephone_number": "704-569-3130",
            "fax_number": "704-569-9797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9123 MONROE RD STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282702456",
            "telephone_number": "704-569-3130",
            "fax_number": "704-569-9797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERMENTER CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A",
        "authorized_official_last_name": "PERMENTER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "JASON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "704-569-3130",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "963043003",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "790838F",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0838F",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA - PPO",
            "identifier": "7572054",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEECH STREET",
            "identifier": "2117085094101",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA - HMO",
            "identifier": "3467419",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN",
            "identifier": "606834-980061",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; 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.