Individual provider Active NPI

Samuel Keith Andrew, D.C.M.AC.

  • Chiropractor
  • Albemarle, NC
National Provider Identifier
1861498040
Registry record updated Oct 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1787 Issued in NC
Practice address
330 N 1St St
Albemarle, NC 28001-3905
Phone
(704) 983-3552
Fax
(704) 983-4660
NPI assigned
Jun 22, 2005
Last updated
Oct 10, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1787 NC Primary

Addresses

Primary practice location

330 N 1St St
Albemarle, NC 28001-3905

Mailing address

330 N 1St St
Albemarle, NC 28001-3905
Phone (704) 983-3552

Other identifiers 1

IdentifierTypeStateIssuer
8908215MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110901000000 NC Practitioner - Chiropractic 4688677974 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Andrew Chiropractic and Acupuncture Clinic, PAGroup PAC ID 2961405253, 2 clinicians

Practice addresses (Care Compare)

330 N 1St St
Albemarle, NC 28001-3905
Phone (704) 983-3552

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Andrew Chiropractic & Acupuncture Clinic, PA Chiropractor CurrentSince Oct 1, 2001 Accepting new patients

Locations

330 N 1st St
Albemarle, NC 28001
Phone (704) 983-3552

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191974400000",
    "number": "1861498040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 N 1ST ST",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280013905",
            "telephone_number": "704-983-3552",
            "fax_number": "704-983-4660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 N 1ST ST",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280013905",
            "telephone_number": "704-983-3552",
            "fax_number": "704-983-4660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREW",
        "first_name": "SAMUEL",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "D.C.M.AC.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2007-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "1787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8908215",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albemarle, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.

Verify at the official NPI Registry.